Become dentally self_sufficient
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Become dentally self_sufficient Document Transcript

  • 1. HOW TO BECOME DENTALLY SELF-SUFFICIENT Published by OraMedia PO Box 496, Elmira, NY 14902 Library of Congress Catalog Card No. 79-90865 International Standard Book No. 0-933420-01-3
  • 2. Foreword Why become dentally self-sufficient? Whats in it for me? What must I do to become dentally self-sufficient? Physiology--the anatomy of the mouth A summary of odontosis Materials & equipment Oral self-help medicine Your personal oral health maintenance program Special-purpose hygiene methods Home prophylaxis: an oral health "insurance policy" Saving orthodontic dollars Oral first-aid measures What you should know and do about dental pain1
  • 3. Diet, nutrition and oral health X-Rays vs. Saliva Tests: ...which is best? From now on Catalog of publications Foreword Knowledge is the key to health. Knowing what to do, how to do it, and why to do it can helpyou and your family live sensibly. You can enjoy not just freedom from dental disease, butfreedom from the expense and futility of dentistry itself. Because knowledge is such an essential ingredient, it would be to your advantage to have, inaddition to this book, two other OraMedia publications; Research Advocates Oramedics andMoney By The Mouthful. The information contained in these two books will be included in this book, but not in asextensive detail. Most people who obtain this book will do so because they were introduced toOramedics via these other books, and this one is written more for the "advanced" is anatural extension of what theyve already learned.1
  • 4. In these pages you will find all the information needed to become self-reliant in caring foryour oral health. Youll understand the cause of dental disease, youll learn how to avoid it; youlllearn what to do for infants, older children and adults. Youll discover what natural resources areavailable to help you maintain a healthy oral environment as well as what effective materials areeasily obtainable through any well-stocked drugstore. You will find that as with virtually anything in the health spectrum, the first and best"medicine" is prevention, but we realize that there will be problems in spite of your preventiveefforts...and we will help you understand these problems and what to do about them: A sort of"dental first aid" approach. If you havent encountered the term "frame of reference" by now --or if you have, but dontfully understand it --you should be aware of its importance to your use of the information in thisbook. A frame of reference is the way you view any given subject, based on preconceived ideas...on all of the concepts and misconceptions youve acquired relative to the subject at hand. The typical frame of reference to oral health is woefully incorrect; but it is nearly impossibleto understand and to use correct information unless the old frame of reference is changed.Whenever you encounter that phrase in this book, think of it as a reminder that the informationyou are reading at that point is something that is contrary to "popular belief", and that you shouldperhaps slow down at that point and give it extra attention. Why are you about to read this book? --isnt it because youre convinced you havent beengetting the whole truth from the dental profession? Youre quite sure that if you only knew how,you could take excellent care of your health, and your familys health, without encountering thebackbreaking (and rising) medical and dental costs of our time. Youre not alone. In fact, pollster Louis Harris wanted to find out how many people think likeyou do, and so the famous Harris Poll went out and dug up an interesting fact: More than nine outof ten Americans share your growing belief that simply living sensibly will do more good thanany doctor or medicine. That same poll showed that perhaps seventy percent of the public believes doctors could begood sources of help --information --on how to stay healthy... but only forty-seven percentbelieve doctors will give them the advice they need. Nine out of ten suspect that somethings not quite right with what theyre told. Seven out of1
  • 5. ten think professionals could help them. Less than half believe the professionals will help them. No, youre not alone; and that perhaps accounts for the mushrooming acceptance ofOramedics: Americans, now more than ever before, are ready to recognize and to use commonsense approaches to health care. We think thats why you are about to read this book. We knowthats why it was written...1
  • 6. Chapter One - Why Become DentaIly Self-Sufficient? In early April, 1979, authors Dr. Nara and Steven Mariner attended a conference inMilwaukee, Wisconsin. The purpose of the conference was so that National Aeronautics & SpaceAdministration (NASA) bio-medical engineering experts and highly-placed members of theAmerican Dental Association (ADA) could compare notes on the "state of the art" of dentaltechniques. It was intended to be an exposition of how to bring the best of dentistry to people in remote,inaccessible areas --perhaps as a fore-runner to populations in space; certainly in response toareas of the world where dental offices are impossible and dentists are scarce. It was, from the viewpoint of most of those present, a smashing success. As far as Oramedicsis concerned, it was a discouraging failure --except that it underlined the crying need, for the public to have access to the kind of oral health approaches Oramedics hasdeveloped. The crowning achievement of American technology was to bring space-age materials andtechniques to bear on equipment. The conferences high point was when people learned that wecan now take all of the archaic devices from a dentists office... the barber chair, the drillingequipment... the works... and put them into a back pack weighing in at just under 100 pounds. Now a dentist can hire a porter to lug his office up a mountain, or through a jungle --or into aspace vehicle --and, once hes arrived at his destination, he can set up shop and... right. Drill holesin someones teeth, or yank them out. It is discouraging and frustrating to see such an enormous expenditure of money andtechnology just to keep alive the fiction that diseased teeth are inevitable; and that the only personwho can do anything about disease damage is a dentist with his mechanical tools. It makes nodifference whether the office is up a flight of stairs over the dime store... or on someones back, ata miracle of only 97 pounds. What on earth --or in space --is that person doing with holes in his teeth to begin with?Dental disease doesnt have to happen! We might as well imagine the spectacle of doctors lugging iron lungs around with them,looking for victims of polio in remote areas... so they can keep the victims alive for just a littlewhile longer... but without taking along any Salk vaccine to prevent the disease in folks notalready stricken. Dental disease --odontosis --is the result of an invasion of germs into the oral environment. Itcan be stopped at any stage of its development, simply and economically. It can be prevented. Ifodontosis is inactive, there wont be any more holes in the teeth. If its stopped before itprogresses too far, there wont be any "yanked" teeth... or, as is predictable with the current "stateof the art" for conventional dentistry, the ultimate loss of all the teeth. Nobody can "blame" NASA for spinning its wheels on product development: The only sourceof information about dentistry is organized dentistry... and organized dentistry is still practicing"drill, spit and fill" techniques given up decades ago by the town barber. It comes down to this: Theres only one way for people in remote areas to avoid the pain anddanger of disease-damaged teeth: They must learn to avoid the disease. There is no other sensibleway for people in "remote areas" --and that covers a lot more territory than on the moon. People in ghettos are in "remote areas" --how many dentists practice in such places? Wherewould people get the money to pay them?1
  • 7. People in rural America are in isolated places: Who can afford to lose a days work; to drivemany miles to a dentists office, often only to be told to come back again in a few days time? Being isolated is as much a function of economics as it is geography: A person earning $140per week take-home pay is as isolated as an astronaut as far as dentistry is concerned, even if helives and works within walking distance of an office. People are "isolated" from dentistry by distance, by economics, by misconceptions as to whatdentists do (or dont do). People can be intentionally isolated from dentistry; especially thegrowing number of Americans who simply do not trust the medical / dental establishment to tellthem the truth about self help methods. The Harris Poll discovered in 1979 that 92% of all Americans believe simply living sensiblywill do more good than any doctor or medicine. They are correct in that assumption, as far as oral health is concerned! It isnt too surprising,given the somewhat astonishing "track record" of the American Public, that people seem to comeup with the correct attitude in spite of the "official" attitudes handed them by the establishment. In that same poll, less than half of the people interviewed believed they would get the rightkind of advice from their doctors. When you stop to realize that those "doctors" are the same sortwho are encouraging NASA to spend millions of dollars to develop back-pack dental offices, it isrefreshing to realize how difficult it really is to fool the American Public indefinitely. Organized dentistry has been able to fool "all of the people some of the time; and some of thepeople all of the time" --but, fortunately, the era is over when they could fool all of the people, allof the time. Those who have read Money By The Mouthful are aware of the resistance Oramedics hasencountered in its attempt to tell people that dental disease is unnecessary. In Money By TheMouthful it was made clear that organized dentistry responds to symptoms, not disease. Thosewho read that book --many thousands of people --asked Oramedics to publish another; one thattold them how, in simple terms, to become dentally self-sufficient. Thats what this book is all about. A suggested method of using it would be to read it rightthrough, cover to cover, without stopping to "study" any part of it. Youll find that yourunderstanding of dental disease (which well call odontosis from now on) will increase as you goalong. Youll notice several reference chapters which you can use as guides, or to refresh yourmemory, when specific needs arise later. Youll come to view this book as a sort of "home medical advisor," but with a total emphasison oral health. There are chapters on how to care for infants and for youngsters as well as adults.There are some relatively technical chapters which discuss disease mechanisms. These arenecessary for your understanding and --while technically accurate --they are written in plainlanguage. This book will not qualify the average person to be a Doctor of Dental Surgery (dentist); anymore than a medical or first-aid book would qualify a layman to be a physician, an M.D.Situations can arise which are simply beyond the scope of this book or which require training andskills beyond the reach of a lay person. An accident which breaks teeth or severely cuts gumtissue, for instance, would obviously require medical / dental attention. Its possible that severe disease symptoms could arise, causing intolerable pain or systemicpoisoning. It is no comfort, at that point, to realize that it could have been avoided. If the situationexists, it must be dealt with. In the event of any condition which isnt clearly understood, or where there is evidentpotential for serious difficulty, the intelligent person will seek help from a professional. One of the purposes of this book, in addition to helping people become self-sufficient for amajor percentage of their oral health needs, is to give them greater competence in deciding whenand where to seek medical assistance... when that assistance is available. Of course the emphasis throughout will be on prevention of odontosis: The primary goal ofOramedics International is to help people achieve freedom from disease. When the oral1
  • 8. environment is disease-free, the person will have become totally self-sufficient. The reader is encouraged to write to Oramedics International if there are any questions. Everyinquiry receives the personal attention of a staff member and more often than not will be referredto an Oramedics Fellow, a practicing Doctor of Dental Surgery. AII inquiries are answered. Mailshould be addressed to: Oramedia PO Box 496, Elmira, NY 14902 E-mail: on; join the ever-increasing number of Americans who are achieving freedom fromdental disease. We think you deserve better than inventions which allow conventional dentistry tobring an office into your living room --or in a mobile van --or on the moon --in order to plugholes or pull teeth that shouldnt have been sick to start with. We rather like the idea of a muchearlier inventor, Thomas A. Edison, who said: "The doctor of the future will give no medicine but will interest his patients in the care of thehuman frame, in diet, and in the cause and prevention of disease."...Welcome to the dentistry of the future --today.1
  • 9. Chapter Two - Whats in it for me? Even if Madison Avenue hadnt taught us to be aware of "whats in it for me?" we would still,sooner or later, evaluate the cost-effectiveness of anything we do, in order to decide if its "worthit." There cannot be any real effort --and therefore no progress --without incentive of some sort.This is as true with oral health as with anything else; and there is no way you or your family willinvest the money (although it is very little), or the time and effort to overcome odontosis andbecome self-sufficient, unless you are first convinced there is something of real value to gain. Organized dentistry is betting that you cant do it, and they are more than willing to providerepair services for a fee when this self-fulfilling prophecy comes to pass. This attitude is well expressed by the author of an article in Journal of the American DentalAssociation (V. 95 {1159}12/77), entitled, Patient Susceptibility Limits to the Effectiveness ofPreventive Oral Health Education: Prevention is preferable to repair of damage. During the past few years the most significantdevelopment in the prevention of dental disease has been the movement to incorporate patientoral health education as a service routinely offered by many private practitioners. The goal ofsuch programs is to develop in patients a self-maintaining habit of daily mechanical disruption ofplaque. From the perspective of behavioral science, little evidence supports the hope that suchbehaviorally-based preventive programs will be a significant deterrent to dental disease...Homecare prevention is not for everyone; in fact the number of people who could benefit from suchinstruction may be no more than several hundred per dentist...(emphasis added) The JADA editors introduced this article with a boxed lead-in which flatly stated, "Apreventive oral health care regimen will not succeed for every dental patient." Theres no purposein belaboring the point, although there are probably hundreds --if not thousands --of dentalarticles describing why patients are "too dumb" to take care of their own oral health. Sincedentists are exposed to these attitudes when they enter dental college, and the pressure never letsup after they enter private practice, its no wonder most dentists have a defeatist attitude aboutyour capability to learn commonsense approaches, and then do them. Contrast this to the thousands of case histories in the files of just one Oramedics practice. TheJADA article said "...the number...who could benefit... may be no more than several hundred perdentist." This article is talking about people just like might even be talking about you. Oramedics patients, also, are people just like you. Is there any reason to believe that "onlyseveral hundred" have benefited from that one practice? To prove the effectiveness of theOramedics program, a sample of 1,000 records was selected at random from a total of over10,000 patient files. The average condition at the time of initial patient examination showed an average U.S. NavyPlaque Index count of over 17; and an average lactobacillus acidophilus germ count of 483,000per milliliter of saliva, and with an approximate average of one half billion streptococcus mutansgerms per milliliter. The sampling included patients from ages three through 84; covering a period from 19621
  • 10. through 1978 (17 years). Because of the average condition upon initial examination, as describedabove: 92% had evidence of active decay: 98% showed definite evidence of inflamed or otherwise diseased gum tissue at the time of initial examination. The sampling showed that some four percent of the records were incomplete, since thepatients had refused the Oramedics program and had left the practice. Another five percent of thepatients had moved away, or for some other reason could not be evaluated as part of this survey.Aside from these "incompletes" or "no longer actives --which comprised only nine percent of theoverall sample group --did the results prove anything about the effectiveness of Oramedics? Hereare the results: Upon final examination on whatever date their six-month re-examination fell closest to 15February 1978, the results were as follows: Average US Navy Plaque Index --2.2 Average Lactobacillus count --720/ml. Not one patient was found to be experiencing any active decay or any evidence that the decayprocess was occurring. Not one patient was found to be experiencing any active gum tissuedisease. Why do you suppose that patients in this one dentists practice were able to consistently "beatthe odds" against disease? The Journal of the American Dental Association article seemed topretty well conclude that most folks simply cant get it together as far as their oral health isconcerned. What makes the difference...? Lets take a look at three letters, all written in 1978: I was Dr. Naras chair-side (Registered Nurse) assistant for over 10 years (1964 to 1975).Being a nurse I suppose that I paid even closer attention to my bosss work than an averageassistant. During the ten years I never saw a single patient who required a filling whose routineNavy Plaque Index was below 3, and whose lacto count routinely registered below 8,000! In myopinion Oramedics will stop dental disease for anyone who follows the concept. --Patricia J. Salani, R.N. I worked for Dr. Nara during 1972 and 1973 as an assistant, both in the office and in thetreatment rooms. During that time my attitude towards dentistry improved 200%. All patients on the Oramedics plan kept their mouths in great shape. It was always a "teameffort" --Dr. Nara, his staff, and the patient. The whole concept makes sense...Oramedics works. --Peg LaBissoniere I have been involved with Oramedics for roughly one year. As a hygienist, I have had theopportunity to personally examine hundreds of Dr. Naras patients. In the majority of these patients I observed the routine standards of Oramedics: Navy PlaqueIndex below 3 and the lactobacillus count below 8,000. Where the mouth was enjoying the Oramedics safe zone I never observed a single area ofnew decay, nor did I detect anything but perfectly healthy gum tissue. It is my professional opinion that as long as the patient maintains the Oramedics standard it1
  • 11. is practically impossible for them to develop any dental disease. -Alice T. Rauschkolb, Registered Dental HygienistThe point we are not trying to make is that when the Navy Plaque Index is below three and thelacto count below 8,000/mi there wont be any disease. Thats been proven so incontrovertibly itneeds no further argument. The point of this survey, and those letters from professional dentalassistants, is this: In this practice, every active patient went from oral disaster to disease-freehealth. All of them... except the four percent who chose to remain diseased and the five percentwho were registered as "incompletes." Weve already stated that Oramedics offers no "secret medicine," no mythical pill orinoculation which wards off odontosis. To date, there is no such medication (although Oramedicsis working on it). What, then, makes the difference? It is so simple that the entire point can be missed "in thewink of an eyelash." One of the most difficult adjustments to the typical frame of reference isinvolved here, and the statement is so deceptively simple that you must pay careful attention: Conventional dentists really dont tell their patients how. Oramedics Fellows do. Conventionaldentists really dont tell their patients why. Oramedics Fellows do. Conventional dentists haventdiscovered a means of motivating people to care for their own oral health. Why, how and motiveare what Oramedics is all about. The answer to "whats in it for me, as far as oral health is concerned, is the key to yourbecoming orally self sufficient. Comedian George Carlin once said, "You gotta wanna." Isnt thistrue of everything in your own life with any value? In order to achieve, to acquire, to do... You have to want to. But theres another side to this, equally important to the human psychological makeup.Wanting to do anything is never enough, as long as the person remains convinced that what heor she wants is out of reach. Thats the critical factor in the war against odontosis: Most people,dentists and laymen alike, may want to do something about this disease...but they dont reallybelieve anything can be done! It took years of effort and research before the principles of Oramedics were developed to thepoint that the average person could believe odontosis was preventable; that the average, ordinarycitizen could defeat this disease forever. Until this becomes the governing frame of reference,theres little hope that the personal attempt at freedom from disease will be effective. You have to want to, sure...but thats not enough. You also have to believe you can! Thats the whole point of telling you about the survey of Dr. Naras patients...and sharingthose letters with you, letters written by oral health professionals. Thats the point of Money ByThe Mouthful, the companion to this book...and it is the point of much of what youll read fromhere on. Once more, for effect: Your frame of reference about odontosis now must become that alldental disease is wholly preventable today --and that ordinary folks, using ordinary materials, areable consistently to achieve freedom from that disease. Once you become wholly convinced that this is an achievable goal, youre halfway to theright frame of reference. The other half, of course: You have to want to. Whats in it for you andfor your family almost goes without saying, but there are a few statistics you may find interesting:1
  • 12. Take a look at illustration 1, a graph of oral health costs. While its obvious that we aretalking about an average --your own case will be either less costly or more costly than $16,500over a lifetime the ratio would still be fairly applicable. The cost of reparative and replacementdentistry is something on the order of seventeen times as expensive as preventive oral health care. The comparison of financial outlay, as revealing as it is, misses one point completely: Manyfamilies or individuals simply cannot and do not invest anywhere near this much money in theirdental health. In many cases, at around age 40 (when the graph takes a sharp upward curve,financially) the person simply "gives up," electing for dentures rather than the burdensomeinvestment needed for bridgework, root canals, etc. Your money or your teeth, fate seems to be demanding when we hit early middle age...youapparently arent allowed to keep both. And thats wrong! What other incentives are there to become dentally self-sufficient, besides financial gain andthe "right" to keep your teeth for a lifetime? -What about freedom from pain? Anyone who hasever experienced a toothache will be able to see the incentive in not suffering another. Anyonewho has ever had an abscessed tooth, or undergone a painful extraction, or who remembers themaddening sounds and sensations of having a tooth drilled and filled, will fully understand theincentive of not going through these things again. Theres more: Anyone who has paid the price of having a childs crooked teeth braced, andwho learns that this, too, could probably have been avoided ...will understand the incentive ofgood oral health. Parents who love their children and who want to help them avoid the socialproblems of diseased or crooked, unsightly teeth will understand the incentives involved. Incentive...? This whole book should help you with your incentive to become dentally self-sufficient; and thats good, because we cant do it without you. Becoming self-sufficient impliesthat you are going to make a self-investment. If you are content to let others do things for you,you have no reason to continue with this book, or this program...because it wont work for youunless you work for it. We cant make you dentally self-sufficient unless you do your part. For our part, we canprove to you that it will work; and we can show you how. We can even give you all theinformation necessary to prove to you that you can do it; just like thousands of other "ordinarypeople" before you. We can help you understand why and how. Thats our part.--Whats your part? ...Easy: You have to want to. Remember the old saying, "Where theres a will, theres a way." Your will, and Oramedics way,can lead you to freedom from dental disease and help you become dentally self-sufficient.1
  • 13. Chapter Three - What must I do to be dentally self-sufficient? In its simplest form, the answer to that question is: You must get rid of active disease in yourmouth; you must make sure you prevent any recurrence, and you must ultimately make somedecisions about having present disease damage repaired. Step One Lets take these steps one at a time. First and most important, there is active disease in yourmouth; there is active disease in the mouths of members of your family. Unless you fall into thecategory of those who are naturally immune, odontosis is at war against your oral health rightnow. Who is immune? --Statistically, some two percent of the worlds population has a highdegree of immunity from odontosis; some of them even seem to have a total immunity. We dont know for sure why this is, but theres a good way for you to determine whether youfall into that category. You can go through the first step, the Lactobacillus Saliva Test, the sameas everyone else. If youve never done anything in particular to keep your oral health ship-shape,and have never suffered cavities or any other oral disease symptom, and if your lacto count isunder 8,000 naturally --you are probably immune. The odds against you are 50 to 1: If you weregambling something besides your oral health, you probably would not bet against those odds, soits a "safe bet" that you have odontosis. Must of us have no problem concluding that we have active disease. Instead, the question is:"What do I do about it?" Before you can begin any response to this disease, you should first be aware of the extent ofthe problem. Dont expect your old frame of reference to work, now. This is nothing like having adentist tell you, " have two cavities..." (or whatever). We want you to begin thinking of odontosis as you would expect to think of diseaseelsewhere in your body. In other words, you should know what causes it and how it operates; andyou should begin to think in terms of diagnosis, clinical tests and individualized approaches totherapy. In Chapter Five youll find a step-by-step explanation of odontosis and its three most easilyrecognized forms; cariosis, gingivosis and periodontosis. You neednt take the time now to studythat chapter --just remember it is there as a reference for your use later. At present all you need tobe reminded of is that odontosis, like so many other diseases, is caused by germs: Lactobacillusacidophilus and streptococcus mutans, to name the principal bad actors. These germs create a waste by-product that makes a film on your teeth --and particularlybetween your teeth --in which the germs colonize. Now another by-product...acid...begins to"insult" tooth enamel, resulting in cavities. The disease process continues, ultimately causing other symptoms which you recognize asgum problems. Frame of reference: Cavities, gum problems, sore gums --often bleeding --toothaches, abscessed teeth... all of these are symptoms. Weve been trained since childhood tothink of these things as the sources of our troubles. They are not the source (cause). They are alleffects (symptoms) of a hidden cause --disease. Now, obviously: If the disease is caused by germs, all we have to do is get rid of the germsand were home free, right? --Well, in a manner of speaking, thats right. But we cant "have a shot" to get rid of these1
  • 14. germs; and there are no pills which will make them "go away." If we did have such an injectionor medicine, youd simply end up "catching" these same kinds of germs all over again, sooner orlater. We have to get rid of them, and keep them absent, in order to be free of odontosis. And so,like so many other diseases, we begin our war on germs with a test; one which will determine theextent of the present involvement and become a point of departure for our therapy. This test is called the "Lactobacillus Saliva Culture" or, more simply, the Oramedics SalivaTest. It is performed at a laboratory, using a sample of your saliva which you mailed, yourself, ina special container. Technicians at the lab will use special equipment which enables them to actually count thenumber of lactobacillus in a given amount of saliva to come up with the germ count per milliliterof saliva. There is a well-established mathematical relationship of the number of strep mutansgerms present for a given number of lacto germs, and so the technicians can determine the extentof both microorganisms from this one test. When a saliva test is below 8,000 lacto per ml. of saliva (consistently), that mouth is probably--almost certainly --without cariosis. Anything over 8,000 is moving into the danger zone. It isnot unusual for the average person to have a lacto count in the tens or hundreds of thousands permilliliter. This would be true even alter a visit to a dentist; perhaps especially after a trip to a dentist.Why? Colonized germs would have been disturbed by the exploring, drilling or scraping. Thenumber of germs present in "free" saliva would be increased. This wouldnt invalidate the test interms of establishing the presence of disease, it would simply give an incorrect "reading" of theoral environment. It is not unusual to encounter a saliva test result of 500,000 lactobacillus per ml. of saliva.This would mean --incredibly --that there are 500 million strep mutans germs per milliliter. Now, even when youre talking about things as tiny as germs, anybody will recognize that ahalf billion of anything is a "whole bunch" of em. Considering that the only "safe" level of thesegerms is less than 8,000...the saliva test instantly tells us: 1. Whether disease is present (confirming your suspicion); 2. What extent the germs have set up housekeeping; 3. What logical steps to take from here on out. For an analogy --although admittedly its like comparing oranges to tangerines, which arentquite the same --think of a doctor being almost sure, from symptoms, that you have diabetes.Would he immediately start you on insulin therapy without making any tests, without analyzingyour individual, personal situation? --What if he was wrong; the symptoms seemed like diabetes,but that wasnt really the disease? Or...what if he was right? Should he prescribe oral insulin, orinjections? How much? How often? What about your diet: Would he simply suggest that you"avoid sugar, and visit your doctor every six months for a check-up?" No, of course he would do none of these things. He would use a well-established, definitiveclinical testing approach so that he was sure; and so that he knew what you need, as an individual.Then --and only then --would he discuss things like medicine, therapy, diet control, and your ownresponsibilities in achieving personal freedom from disease.1
  • 15. To take the saliva test, you first obtain a specimen bottle and instructions. Oramedics offersthis through the mail. As with many other things, Oramedics is not the only place, ororganization, which offers saliva tests...but they are hard to locate even for conventional dentists,who usually dont bother with them. Finding a laboratory which would deal directly with thepublic would be extremely difficult. If you can obtain satisfactory testing elsewhere, and want to, of course you should. If not, youmay obtain the saliva specimen bottle and instructions from Oramedics. Once you have this, you will, upon rising in the morning, chew a small piece of sterile waxprovided in the test kit, then spit in the special bottle, seal it tightly, and drop it in the mail. It ispre-addressed to the laboratory. The laboratory will return its findings to the doctor or agency sponsoring your test and,together with the other personal history youve given, it can be used to establish a diagnosis aboutthe present state of your oral environment, and suggest a course of action to correct it,individualized for your personal condition. A second benefit of the saliva test is that after you have begun the recommended corrective"treatment" you can check your progress by re-testing at appropriate intervals. Obviously,secondary testing can reassure you that you are progressing...and it can also disclose anycontinuing problem. You may have unsuspected nutritional difficulties. You may have a severe dietary problem.You may have need for closer supervision or additional instruction. For whatever reason, if youare embarked on a program of becoming self sufficient, the tests will show you absolutelywhether your program is working --or whether you need additional help. "To test is to know...not to test is to guess." For those who are enrolled in the full through-themail Oramedics self-help program, the testing is mandatory...and for a very good reason.Oramedics doctors refuse to guess, on a matter as important as a patients oral health, when it isso easy and virtually foolproof to test. Step Two After testing, the next step in your program of oral self sufficiency is to learn about oral hygiene.Be careful of your present frame of reference on this point. because there are hundreds ofthousands of Americans wandering around out there, convinced they are taking good care of theirmouths...and they are not. More than ten years ago, writing for other dentists, Dr. Basil G. Bibby, D.M.D., wrote anarticle, "Do we Tell the Truth About Preventing Caries? in the Journal of Dentistry for Children,Vol. 33, 1966. Lets "drop in" on that article, shall we? There have been few more successful educational programs than the one which hasconvinced the American people of the desirability of tooth brushing as an adjunct to oral hygiene.It now rates close to motherhood in respectability. Its promotion gives the dentist something totalk about and the dentifrice manufacturer good advertising angles. Commerce being what it is,the manufacturer cannot be blamed if he oversells oral hygiene for the purpose for which he is inbusiness. The same cannot be said of the dentist, whose very title of Doctor suggests that heshould be teaching the most up-to-date information on the subject.1
  • 16. Dr. Bibby then asks other dentists: Is it correct to say that brushing the teeth will prevent dental decay, or have we repeatedthis statement so often that, as the ultimate victims of propaganda, we have become incapableof questioning it? One does not have to be against brushing the teeth to question its value inpreventing dental decay...Emphasis added No, Oramedics is not "against" tooth brushing. (Were not "against" motherhood, either...)What Oramedics wants the world to know, even if the profession doesnt (yet), is that toothbrushing alone wont do the job; and tooth brushing ineffectively is --aside from making you feelgood cosmetically --probably a waste of time. Worse than that: If you are a conscientious tooth brusher, and have believed the toothpastecommercials, you are with dentists as far as Dr. Bibby would be concerned: You are an "ultimatevictim of propaganda." You are a victim, in this case, because youve come to believe (frame ofreference) in your efforts at oral hygiene: You feel that youre doing all you can and should do.That attitude leads, almost inevitably, to matter what you think your tooth brushingis doing for you. You will need to learn a great deal more about oral hygiene; and you will, in this book...afteryouve learned more about the way your mouth is put together, and what the chemistry is like inthere, and so on. For now, please understand that for the rest of your odontosis-free life the one single mostimportant thing you will personally be involved in is oral hygiene. This one area is yours,exclusively and individually: You can be shown how, but only you can provide the initiative andthe persistence it will require. Understand, also, that we are not going to ask you to go to extraordinary lengths, to becomeso involved in oral hygiene it becomes oppressive. In fact many folks have discovered that theright approach to oral hygiene is less time-consuming, less restrictive and easier to maintain thantheir former hit-and-miss, guilt-laden routine of alternate frenzy and lapse; self satisfaction anddespair. Step Three The next stage of oral health self sufficiency is to become knowledgeable about teachingothers in your family; caring for babies, infants and children. You should (and will) also come toknow about how to respond to toothache pain and what to do in emergencies: Oral / dental "firstaid." In order to help you with this, we will take you in easy steps through the necessary technicalinformation. You wont be deluged with big words and abstract concepts, although well make apoint of telling you what some of those big words mean; and what some of those concepts imply.It is during this phase of your reading and doing that you will become familiar with the chaptersof this book that, later on, you can use for your reference library.1
  • 17. Step Four Sooner or later, you will probably require the services of a dentist. Youve had odontosis longenough now, probably, that there is irreversible damage to your teeth. We are speaking of damagewhich nature cannot repair without assistance, when we mention irreversible damage: The kindwe are now talking about is repairable damage. In a sense, the distinction is that you will need to have some things fixed that cant be healed.For those problems, the only solution is reparative dentistry: The kind of dentistry that anycompetent Doctor of Dental Surgery is prepared to perform. This is not a contradiction, in a book about becoming self sufficient, when we suggest thatyou will ultimately have to obtain corrective help from a doctor. Only a doctor has the requisitethousands of hours of education, the skill and experience, the equipment, and the legal right toactually "operate" on your teeth. While it should be the last time you require this kind of help, the odds are that you will haveto have it at least once more after youve become self sufficient. For that, we will help youunderstand what is needed and how to go about getting it done properly. In brief, you will firstachieve freedom from disease; then freedom from earlier symptoms... and then remain free ofboth the disease and the symptoms.1
  • 18. Chapter Four - Physiology - the anatomy of the mouth We could have titled this chapter What goes on in your mouth, to avoid using words thatcreate images of musty classrooms and dull subjects. However, your understanding of your oralhealth depends to some extent on your knowledge of --well --what goes on in your mouth; and toconvey that understanding, we need to go into some accurate details. To take some of the negative connotations from those two words, lets look at how onedictionary defines them: Physiology --The science dealing with the functions of living organisms or their parts. Anatomy --The science dealing with the structure of animals and plants. In this chapter we are going to look at the structure of your mouth (anatomy); and were goingto go into how those parts work together in natural harmony when your oral health is good; andhow those parts sometimes come into conflict when your oral health is bad (physiology). If that isnt "what goes on in your mouth," it will do until better definitions come along.Before now, if you are like most people, youve always thought of your mouth as one part of thebody that "just is," without any rhyme or reason. When it works, its okay; when you "get badteeth," its unavoidable --and when, after middle age, your teeth fall out or get pulled out to makeway for 2500 worth of plastic junk, thats the way nature planned it...right? --Wrong! As with every other part and process of the human body, we are learning more and more thateverything nature puts into the package has a value. When these parts are working together asnature planned it, good health is almost invariably the result. What can prevent the proper operation of these parts? What actually causes ill health? A fairgeneralization would be that we have only two enemies fighting against our natural health--Natural enemies, and--Ourselves. It seems odd, upon reflection, that all of us dont know a lot more about our oral health thanwe do. After all, we are an educated people. Why is common knowledge so lacking when itcomes to our mouths? Why is oral health such a mystery? Perhaps it has something to do with the time lapse between professional, scientificunderstanding; and the "trickle down" process whereby that understanding reaches public schoolsand "general knowledge." Science hasnt known much of the truth about the mouth until comparatively recent times. Tobegin with, it is a fact that dental science has not kept pace with other physical and medicalsciences. The store of dependable, factual knowledge about oral health is just now beginning toplay catch-up with other medicine. This makes it even more interesting to note what one authorityin medical research had to say:1
  • 19. the age-old struggle to promote medicine from a craft to a science there has been moreprogress in the past thirty years than in the previous two thousand. This progress is not as suddenas it seems. What is happening is that earlier discoveries about the natural history of health anddisease are now being applied in the actual diagnosis and treatment of illness... Many of the newer methods of treating and preventing illness depend on the patientsunderstanding and co-operation. Hippocrates, 24 centuries ago, said that a doctor must teach hispatients to care for their own health, but until recently most doctors seem to have thought it wasbad for patients to know too much...--Wingate, 1412 (emphasis added) Two comments on Wingates statement are in order. First: "Earlier discoveries about naturalhealth and disease history are now being applied." In the library at Oramedics International thereis a copy of an extremely rare antique book written in 1819 by Dr. Levi S. Parmly. He wrote,"The brush should at first be but gently applied, and then particular care taken to pass the waxedsilk in the interstices, and round the necks of the teeth, where lodgements of the food (the causesof disease) are usually formed." More than a century and a half ago, this dentist made an accurate, brilliant deduction from hisdiscovery, and for the first time, ever, told people what to do to prevent oral disease. His findingswere not based on scientific research but upon simply and thoughtfully observing the naturalorder of things and using his brain to come up with some solutions. The other noteworthy thing about Dr. Wingates comments is that he freely admits themedical profession has all but ignored Hippocrates 24-centuries old admonition that doctorsshould "teach patients to care for their own health." Given these prevailing attitudes in the professions; and the fact that most of the significantresearch advances have taken place within three or four decades at the most, it becomesunderstandable why "common knowledge" about oral health is still somewhere in the dark agesof superstition. There is no way the public would know about these things until the professionfirst understood them and then, secondly, was willing and able to tell patients about them. We will begin our quest for knowledge about the physiology and anatomy of the mouth byfirst outlining the boundaries: We are talking about everything from just inside the lips to the rearextremity of the tongue; and will include a look at teeth, bone, tissue, muscle, glands, nerves andblood vessels. Teeth fit into the jawbone in what we commonly call sockets, and which are correctly termedalveoli; small cavities or sockets in the body. The singular term is an alveolus, and the wordsdescribe any body cavity--such as, for example, the air pockets inside the lung where the carbondioxide-oxygen transfer takes place. The development of teeth in children is of concern to all parents and it is important to realizehow critical diet and nutrition are to healthy teeth. In a child, while the baby teeth are all visible,the permanent teeth are forming... in many cases, are nearly completely formed... and are waitingin alveoli beneath the baby-teeth sockets. While we cant see them --and the child cant "feel"them --they are there. At one point during the dental development, there are 52 teeth competingfor space in the oral structure. Actually, the first activity in the formation of teeth commences sometime during about theseventh week of the mothers pregnancy.1
  • 20. It is totally incorrect to assume that we have no concern for oral health in children until theirteeth begin to appear. In Chapter Nine we will go into ways of caring for infants and youngchildren; for now we need to understand that dental and oral health first begins in the embryo. After birth, long before any teeth have broken through the gum (erupted), physical processeshaving much to do with ultimate dental health are active . Calcification of the permanent teeth begins shortly after birth and begins to accelerate atabout the time the baby teeth begin to erupt. It becomes apparent that proper care for mothersnutrition during pregnancy, and for the infants nutrition during the early months and years of life,will have a far-reaching effect on that childs adult dental health. Children’s teeth begin to appear, and continue to erupt, approximately on this schedule: lower central incisors six to nine months upper incisors eight to ten months lower lateral incisors/first molars fifteen to 21 months canines 10 to 20 months second molars 20 to 21 months Permanent teeth will replace the baby teeth; ordinarily with those in the lower jaw slightlypreceding teeth in the upper jaw. The schedule for permanent teeth is approximately: 6-1/2 years first molars 7th year two middle incisors 8th year two lateral incisors 9th year first bicuspid 10th year second bicuspid 11th to 12th year canine 12th to 13th year second molars 17th to 21st year third molars C. S. Tomes, Grays Anatomy Illustration 2 is a cross section of a typical tooth, showing the principal elements of itsstructure. Note that the entire exterior of the tooth which protrudes from the gum is covered withenamel. This is a barrier tissue: More about that later in this chapter. Beneath the enamel is alayer of dentin which surrounds the nerve chamber. The roots of the tooth of course are part ofthe system which anchors teeth to the jawbone; notice that they also contain passageway for thenerve and circulatory system serving that tooth. (The tooth in Illustration 2 also showsdevelopment of odontosis; see explanation accompanying that illustration.) The outer covering of the roots is a material some what similar to enamel but softer and lessresistant to attacks by acids and/or microbes. It is called cementum. Not shown in the illustration --because it would be virtually impossible to draw themanywhere near actual scale --are the thousands of microscopic connective tissues which helpanchor the tooth to gum and jawbone. These are extremely important to oral health. Comparethem to the guy wires that hold telephone poles upright against lateral strain. These tiny and individually quite fragile connective tissues completely surround the tooth,anchoring it to the adjacent gum and jawbone. Performing a role very similar to guy wires, they1
  • 21. hold the tooth in place and prevent it from becoming "loosened" in its socket; they also act asshock absorbers when chewing or "grinding the teeth." Studies show that teeth withstandpressures upwards of 30,000 pounds per square inch during these activities, much of it comingfrom an infinite variety of angles. Under such pressures, coming from every direction, the bone of the jaw and teeth wouldsimply crack or shatter if it werent for the anchoring and shock absorbing capability of theconnective tissue. The gums cover the jawbone and the lower portion of the teeth...or the upper portion, in thecase of the upper teeth. Gums do not adhere to the tooth completely; at the gumline (the edge ofthe gum from which the teeth protrude) there is no adhesion. A popcorn kernel "stuck in there" isall the proof needed. Near-adhesion occurs further down inside the gum --the connective tissuescreate what is, for all practical purposes, a bond between tooth and gum. Gums are covered with an outer layer of epithelium --the same kind of body cell structurewhich makes up "skin." In the case of the gums, however, this "skin" is only one cell thick. Someauthorities refer to it as a mucous membrane. In trying to understand how thin one cell ofthickness is, imagine taking a square sheet of this skin about the size of a postage stamp andcuring it so that it was stiff and flat. Now, turn it so that you are viewing this "stamp" directlyfrom the edge-onward: It would disappear. Unaided human vision is not capable of seeingsomething this thin. The outer tissue of the gum is also a barrier tissue, as is the enamel of the teeth. Before we gointo this, lets include the other oral barrier tissues: Beginning with the interior of the lips, the "skin" inside the entire oral cavity is only one cellthick. This includes the covering of the tongue, the walls of the cheek, the bottom and top of themouth... everything. The change from "skin" as we ordinarily think of it, to this unimaginablythin membrane in the mouth, occurs with the lips at a point called the vermilion border. Fromouter cheek, progressing inward, the thickness of epithelium decreases. As we pass the borderwhere the lips become part of the interior of the mouth, the decrease to single-cell thickness takesplace. In spite of its delicate structure, this layer of membrane has the unique property of being abarrier tissue. What this means is that germs and a host of other dangerous or detrimentalsubstances or organisms cant get through it...and it is, ordinarily, not affected by them. This is very much not the case with internal tissue. Muscle tissue, bone marrow, nerve tissue,tooth dentin... and more inside parts of the human system... have no protection from biologicalwarfare. Perhaps the best way to understand this is to think of how youve always known to be carefulwith a "cut" so it does not become infected. Why is that? --Simply because whatever "infects" hasno effect on skin; you simply wash it off and forget it. But --in a cut --whaammo! --Infection, Why does a tooth "decay" if it gets a cavity... and not decay in the absence of cavities? Again:The enamel is not affected by microbiological attack; it "ignores" germs. When you get a hole inthis barrier tissue it creates an avenue of access for decay-causing pathogens, and these attack theunprotected interior of the tooth. Thus, the shining, unbroken enamel of teeth and the healthy pink glow of good gums is farmore important to your health than to your cosmetic welfare. The further from peak health thesebarrier tissues stray, the more likely they are to break down and admit disease-bearing organismsinto the bone and tissue beneath them.1
  • 22. Salivary Glands The unsung heroes of dental health are the salivary glands. Because our society has longconsidered "spit" to be inelegant, most of us remain blissfully unaware of where spit comes fromand what it does for us. Where it comes from is simple: At the rear of the jaw, near the ear, theresa large salivary gland on each side of your head. There are smaller glands at the side of the lowerjawbone and in front, under the tongue. (Did you ever wonder why a dill pickle caused an odd,tight or tingling sensation way at the back of your jaw, almost at the ear?... Now you know: Thesalivary glands react to stimuli and "do their thing" --they make saliva.) What it does for us is a long story. First, of course, saliva lubricates the interior of the mouthand keeps the fragile membranes from drying out; from cracking and splitting. This wetting function also serves to help process food as we chew; creating the rightconsistency and beginning the chemical process of digestion. The almost constant flow of saliva throughout the mouth continually washes the teeth andtissue surfaces, carrying debris into the alimentary canal "pipeline" through the body. Thealimentary canal, incidentally, originates with the mouth and includes in order the mouth, thepharynx, the esophagus, the stomach and the intestines. Saliva contains many chemicals created by the body for the specific purpose of caring for theteeth. Among these are chemicals which enhance healing of cavities, retard the bad effects ofgerm by-products, alleviate the damage of acid and... believe it or not... can "confuse" germs andactually convince them to stop producing acid. On the minus side of the ledger: Part of the chemical composition of saliva which helps torestore the calcium of teeth is also indicated as responsible for deposits of calculus at thegumline. These deposits are the forerunner of gum disease; part of the lineup of "bad guys" inoral health. Of course, if we are properly caring for our oral hygiene these deposits never get a chance tobuild up; so theres no problem. There is little that an individual can do, or avoid doing, to influence the production of salivaor to modify its chemical composition. We simply wanted you to know that the presence of salivais vital to your oral health; and to observe two points of interest which are under your control:1. Production of saliva falls off during sleep; most of us are mouth-breathers or partially mouth-breathers during sleep. All of the benefits of saliva decrease during this period. What can you doabout that? --Avoid going to sleep routinely without first preparing your mouth, through hygiene,for the forthcoming "dry spell."2. Production of saliva and the content of saliva are definitely affected by nutrition andmedication. In Chapter Seven this will be more thoroughly discussed. If, for example, you takeprescription drugs for weight loss or sleeplessness or "nervous tension," (or if you just like to pop"uppers" and "downers" for the fun of it), you are probably seriously interfering with the naturalprocesses of your saliva.1
  • 23. If it fits... Teeth come in during youth and many people suspect there is nothing on earth that willdecide whether they come in crooked or "pretty." Not so: The muscles of the tongue and cheek,the shape and musculature of the jawbone, the location of the alveoli... all of these make adifference. Chapter Eleven describes something called a Mixed Dentition Analysis which can beperformed early in life and which will accurately predict any developing space shortage andalignment problems. If these are detected early enough, the correction is often quite easy andinexpensive. Left to themselves such problems lead to orthodontic correction (braces) with asteep price in both money and cosmetic (personality) problems. Special problems aside, most of us find that our teeth come in fairly well in alignment; theydo a good job of biting and grinding and we seldom think of how they "fit together. We shouldthink about it more often! Adjacent teeth are meant to be close together. It is unusual for the teeth to be spacedthroughout the mouth so as to leave visible gaps between them. A few teeth may be distinctlyseparated, but usually many more of them are so close together as to be thought of as touchingeach other. In some cases, adjacent teeth do contact over at least part of their surface. This touching or near touching relationship between teeth has a naturally beneficial purpose,obviously --or nature would not have used this construction. But it is also adverse to oral healthwhen hygiene is misunderstood or improperly employed. Why? In the section on pathology (the science of the development and mechanisms of disease),Chapter Five, you will learn much more about how odontosis operates. For now, you shouldknow that the confined spaces between the teeth are, from a germs viewpoint, the size ofmetropolitan cities. Most of us follow the dentists advice to brush our teeth with at least some regularity. Someof us even believe in the fable that we are to brush after every meal if we want to be free ofdisease. --Not that its bad to brush often; the fable is that this, alone, will prevent disease. Ofcourse, it doesnt. Very few of us ever learn that one of the most important aspects of competent oral hygiene isto clean between adjacent teeth; and not just so as to make the enamel surfaces cosmeticallyclean... they must become, and remain, hygienically clean. Finally, in discussing the teeth themselves, we should be aware of something dentists call pitsand fissures. No amount of verbal explanation could do a better job of describing and definingthese surfaces than you can do for yourself, with the tip of your tongue. Touch your tongue to thechewing surfaces of your "big" teeth: The molars, the bicuspids...the food grinders, as opposed tobiters. Feel the complex patterns of ups and downs, the hills and valleys (pits and fissures). Some of these hollows are narrow, deep and with interior surfaces which trap food particlesand debris. More importantly, they are harbors for the colonization of germs. Here again, weencounter a part of the oral anatomy that most people take woefully for granted; a part that youmust forever after remain aware of. The pits and fissures are places where you and your childrenhave gotten cavities before...and will again, unless you successfully overcome odontosis. With this expanded understanding of "what goes on in your mouth" you should be able tocontinue reading, and understanding, the disease called odontosis; its effects, its prevention andwhat to do about the leftover damage symptoms of former disease. This is, of course, a minimumknowledge and you are strongly encouraged to read, if you have not already, Money By TheMouthful and Research Advocates Oramedics, which are companions to this book. Another bookwell worth having in your home medical library, and which is available in paperback, is the near-legendary Grays Anatomy.1
  • 24. Grays will tell you virtually anything you wish to know about the human body. For ourpurposes, the section describing the composition and function of the mouth is an outstandingstudy, to which we wholeheartedly commend you. Please refer back to this chapter as often as necessary when you embark on subsequentchapters dealing with the mechanics and function of the disease, or with the elements of personalhygiene. No one part of this book is intended to stand completely by itself, and so you will findmore information on physiology and anatomy elsewhere. This chapter, aside from becoming areference, was intended to assist you in that later reading. Hopefully, you are now aware that your mouth and teeth didnt "just happen," any more thandisease or its prevention just happens. All of the parts in your mouth work in a natural harmonyand when they are working right, with your help, they should last for longer than your lifetime. Maybe thats why Dr. Parmly said, in the forward to his book 150-odd years ago, "The greatdistress which usually accompanies, and the inconvenience which follows the loss of the teeth,makes the discovery of some mode of prevention of caries very desirable." Right on, Levi! --Thats what its all about...1
  • 25. Chapter Five - A summary of odontosis pathogenic: It is caused by germs. Its most apparent symptomsare infections. We are all familiar with this relationship elsewhere in the body. What seemsobvious at first glance is a critical adjustment to the frame of reference, so remember: We arenow discussing dental disease. Bring your old familiarities with you to this "new" part of yourbody. Were looking at a disease mechanism... in the mouth. Cariosis Cavities are holes through tooth enamel into the soft interior, usually with decay (infection)involved. These cavities are symptoms; they are effects, not causes. Dentists often refer to anystage of this process as caries, although properly speaking there is no infection at first. The process is initiated by a carious lesion, the early assault on the tooth enamel itself.Oramedics has named this particular member of the odontosis family cariosis because its mostapparent symptom is the presence of cavities. If cariosis is brought under control the disease process is halted. Even if there has beenmassive damage, the teeth can usually be repaired. In fact, research in the past few years tells usthat teeth with early cavity damage can heal themselves once the disease is eliminated from theoral environment. Gingivosis Puffy, tender, "off-color" gums are symptoms of odontosis in its next stage after cariosis.Dentists frequently refer to this disease as gingivitis. Oramedics calls it gingivosis. Infection anddamage are present, but probably no irreversible harm has been done. Oral bone and tissue havean amazing self-restorative ability once disease has been eliminated. The relatively mild symptoms of gingivosis are deceptively dangerous, however, because themildness often encourages neglect. Almost inevitably, this results in odontosis moving into itsultimate and most critical stage: Periodontosis This is the gravest disease problem in the oral health field; and it is Americas most prevalenthealth disorder. Conventional dentists refer to periodontosis as "periodontal disease,""periodontitis" or "pyorrhea. It is a disease characterized by the formation of pus in the pocketsbetween the root of the tooth and surrounding tissues and is frequently --in fact, almost invariably--accompanied by the loss of teeth. Although cariosis is considered the gravest childhood problem, gingivosis and periodontosisalso commence early in life and become the arch destroyer of adult oral health. The AmericanMedical Association blames a huge share of all physical health disorders on these oral healthproblems.1
  • 26. The mechanism of odontosis The germs which cause odontosis, principally, are streptococcus mutans and lactobacillusacidophilus. These germs are frequently (ordinarily) found in the mouth and, unless they can becontrolled, odontosis will be present to some degree when the numbers of these germs reach acertain level. They are always present in mouths with active odontosis. Most research agrees that when these germs are free floating, in a disorganized condition,they are not particularly harmful. Lactobacillus may even have a beneficial role in whole-bodyhealth elsewhere in the digestive system. There is no evidence that lactobacillus has any beneficial function in the mouth, however; andno evidence exists, which gives streptococcus mutans a beneficial role anywhere in the system. The key to whether these germs are doing harm is to find out how many there are in the oralenvironment. A simple test can provide that answer, and that will determine whether the germsare organized. If they are, theres active disease. It is as simple as that. There is no evidence that the severityof the disease has anything to do with virulence of the germs: There is apparently no degree ofvirulence involved. It isnt how strong the germs are... it is a question of how many there are. The germs feed on food wastes and then excrete their own wastes. One of their products iscalled dextrans. Combined with other debris in the mouth, this sticky substance forms a filmcalled plaque in the mouth, which is then deposited on the teeth. Germs settle in the plaque andform organized and swiftly-growing colonies; making even more plaque in a vicious cycle. When enough plaque has built up, germs get between it and tooth enamel, where they areshielded from air. In this anaerobic environment they not only thrive, they are now able to dodamage. The germs convert sugar into acid. In fact, within seconds after you eat sugar the acidproduction increases enormously and doesnt taper off for hours. The acid is trapped, by theplaque, "dammed up" against the tooth enamel. It is important to note that "sugar" doesntnecessarily mean raw sugar, such as candy. Sugar in this case means any food the germsrecognize as sugar, or that the body can break down into sugar. Carbohydrates are "sugar" as faras this disease mechanism is concerned; the soft white bread so prevalent in supermarkets todayis worse for you than caramel candy! Remember, however, it is not the sugar that causes the acid; it is a disease mechanism. If thegerms were not organized and shielded by plaque, sugar would be relatively insignificant inodontosis. When odontosis is present, however, the acids attack tooth enamel, causing carious lesionsuntil the enamel is perforated. The enamel performs an important function: It prevents germsfrom reaching the softer "insides" of the teeth, which have no defense against infection. Since the inside of the tooth has little protection from decay-producing germs, any holethrough the enamel gives strep mutans, lacto and any other germs in the mouth a doorway intovulnerable tissue. Result: Decay and eventual nerve chamber infection ... the agony and extremehealth danger we call an abscess. While the acids are eating at enamel, plaque continues its dirty work. A buildup of plaque atand slightly below the gumline begins to harden into mineral-like deposits called tartar orcalculus. In effect, small dams are built at the base of the teeth, backing up still more debris andplaque, which in turn hardens into place. Germs --and not only strep and lacto --colonize in these"swamps" where the trapped and decaying oral debris provides food for explosive growth. Tartar and calculus are rough; the sandpaper effect can soon wear through the outermembrane of gum tissue. That external layer is only one cell thick. Like enamel, it is a germbarrier. When that barrier is disabled, the waiting germs have access to inner tissues.1
  • 27. Once again, infection is the result: Gingivosis. Also... any germ which reaches unprotectedinner body tissue can be transported by the blood stream. Many diseases in other parts of the bodyhave their first "breakthrough" inside a mouth suffering from odontosis. Teeth are held in place by numerous tiny, filament like connective tissues which anchor teethand gum together, in a manner suggestive of telephone pole guy wires. They allow teeth to flexenough to absorb the shock and torque of chewing, yet hold them firmly in their proper place,snugged into their sockets in the jawbone. When these miniature marvels of natures construction are attacked by infection, abraded byrough deposits, insulted by acids; they begin to "let go" as they are destroyed. This is the work of periodontosis, the destroyer. As connective tissues fail the gum begins topull away from the tooth, and this widening gap forms "pockets" below the gumline. If thestagnant pools of gingivosis are swamps, then the pockets of periodontosis are cesspools. Everwidening, ever deepening, these pockets can accelerate the destruction of connective tissue; theygive germs access to the bone support of the teeth. Infection --bone infection --often results. The teeth, of course, have lost both connective tissue and bone support. They get loose and, ifunchecked, periodontosis will ultimately claim all of the teeth.1
  • 28. Chapter Six - Materials and Equipment Before we begin a discussion of personal oral hygiene its appropriate to take a look at someof the materials and equipment youll need, or perhaps want, to help you with the job. In thefollowing chapter well discuss some chemicals (medicines) you should know about; this chapteris more of an outline for your home dental care supply cabinet.You should have, at minimum: --One or more toothbrushes for every family member --Dental tape --Disclosing tablets --Interdental stimulators --Dentifrice In addition to these items, you may want to have these materials or devices: --Toothdrops, N.F. (National Formulary). This is zinc oxide--eugenol, and will be discussed more fully in this chapter. --"Cavit" (a ready-mixed temporary filling material) --A hydraulic cleaning device (oral irrigator) such as a "WaterPik" or "Ora-Jet" --A tooth polishing device such as a "Porta-Pro" --An electric toothbrush such as the "Sonic-Quad Pacer" --A special lighted mirror, such as the "Floxite" Before we continue, a word about trade marked items mentioned in this book: Wheneverappropriate to help the reader understand what we are talking about, we will use the brand nameof a common product or device. This does not necessarily imply that the manufacturer of thatproduct endorses Oramedics. It does imply that Oramedics considers that trade marked item orbrand...or manufacturer be reliable. However, no actual endorsement is to be construedunless, in context, specific endorsement is made. Such, for example, would be the case with the "Floxite" mirror. This product is available atsome first-rate dental offices or drugstores and is highly regarded by Oramedics practitioners.Oramedics endorses the product; there is no agreement whatever with the manufacturer regardingmention of either company or product in this book. Now, lets go over that minimum list of supplies, one at a time. First of all: The toothbrush. Rule Number One of toothbrushes is dont buy cheap. The usual frame of reference regard-ing toothbrushes seems to be that they are all alike; people will cheerfully spend more for a bar ofbath soap than they will for a toothbrush. Why is "smelling pretty" more important than oralhealth? --Nobody knows. There is a significant difference in the quality of toothbrushes and while it isnt directlyrelated to cost, it stands to reason that to a certain extent you get what you pay for. An example ofvery good quality name brand brushes would be the "Reach" brush and those made by Butler, andthe "Oral B" brand. Each member of the family should have at least one brush; and it should be selected with afew guidelines in mind.1
  • 29. First: If the oral health is not good, especially if the person has not been a frequent toothbrusher in the past, begin with a soft bristle brush. Its a common misconception that the betterbrushes are stiff; that theyll clean more thoroughly. What they will do, if the person has bad oralhealth, is make the gums bleed and possibly damage barrier tissues --an open invitation toinfection. Second: The relative "stiffness" of the brush can be increased as oral health improves. Asomewhat stiffer brush of high quality is preferred for advanced health hygiene use. Avoidcarefully using a cheapie labeled stiff or firm. It will very probably damage tissues. Third: The shape of a toothbrush has some bearing on how well it works. Any reputable,high quality brush manufactured by a competent supply house will have a better design than acheapie, unless the cheapie is an imitation of a name-brand brush. Even then, the "economy"brush will not have the bristle quality your oral health deserves. The next item in your cabinet should be dental tape. This is a product similar to dental floss,but it is wider. Comparing tape to floss is, for our purposes, like comparing ribbon to thread. Thisis one of the few items available directly from Oramedics: It is manufactured for Oramedics tocritical specifications and is marketed as Oramedics Clean-Between.* In many drugstores, J&J Companys "Dentotape" is available and this, also, is a flat, widertape. Dental floss may be used and if tape is temporarily unavailable, should be used rather than togo without. In the chapter dealing with hygiene, the comparative uses of floss and tape will bemore thoroughly explained. Disclosing tablets are a "must" for your supply cabinet. These are tablets slightly larger thanan ordinary aspirin, made of chewable food dye. For those just starting an oral hygieneprogram...or even for advanced users...and especially for children, the use of disclosing tablets ishighly recommended. Well discuss this more fully when we take a closer look at hygiene. Fornow: The dye in the tablet will stain the film (plaque) generated by germs and deposited on toothsurfaces. It will not stain clean enamel. Therefore, the disclosing dye will tell the user whetherany spots have been "missed" in cleaning the teeth. Interdental stimulators such as "Stim-U-Dent" are specially-shaped, soft wood devices,sometimes flavored. They are not "just toothpicks," although the ends may be pointed and can beused in this manner. One of the purposes of these stimulators is that they may be carried in pocketor purse and used when toothbrush and tape are not readily available. They also have a beneficialrole in the full hygiene program, as will be explained in that chapter. Dentifrice comes in many forms, under many brand names. It is colored, flavored, irradiated,chlorinated, fluoridated; it promises better sex life, kissable breath and movie-star-white teeth.It’s called paste, or powder, or drops...Whats a mother to do....? The only absolute purpose a dentifrice serves is to aid in cleaning the teeth. Given thecontrols wielded by the US government food and drug people and the limits imposed onadvertising, its not likely that you will find a product offered for sale that will actually harm youroral health. But which one helps it the most? Well --that depends on what you expect from your dentifrice. If you are simply looking forsomething convenient, cheap and dependable: Mix up some baking soda and salt and use it as atooth powder. It will help clean your teeth, the soda will counteract acidity in the mouth and thesalt will give you a fresh, clean taste afterward. If the combination of salt and soda is a little bittough on germs...thats tough, right? There are many, many brands of tooth powder available. As a general rule, they cost less andtend to do a better job than tooth pastes. One thing: While you arent likely to encounter a1
  • 30. commercially-available powder with abrasives in it, this is something to watch for. Abrasives,such as pumice, are used to clean and polish the teeth; but almost always in a situation whereprofessional supervision is available. If you encounter an off-brand powder, which makes strongclaims as a "brightener" or stain remover, be sure you ask whats in it. If there are abrasives, avoidit. How about fluoride in tooth pastes? True; sodium fluoride is a powerful weapon againstodontosis. Well discuss it fully in the next chapter. However, any fluoride-containing productyou can buy without a prescription will be limited by law to .05% fluoride content. It wont hurtyou, used as directed; it has been proved that such preparations can have a beneficial effect inreducing cavities. Fluoride dentifrices and rinses sold over the counter are not bad; Oramedics certainly doesntrecommend against them. Our sole objection to these products is in the way they are advertised:People may become convinced that such products can be substituted for proper oral hygienemethods because the fluoride "helps reduce cavities." Not true! --It will "help reduce cavities"; butit is not a substitute for proper care. There are two dentifrices presently on the market which, because of their special-purposechemistry, you should know about. One of these, "Sensodyne", is for people with tooth hypersensitivity. An estimated one out ofseven persons have hypersensitive teeth; the number rising to as many as one out of four inpersons over 35. As you probably guessed, hypersensitivity is a condition wherein the teeth "feel pain" or aresensitive to temperature extremes or touch, as in brushing, etc. This condition has led somepeople to avoid brushing, or to brush improperly, to escape unpleasantness or outright pain. Sensodyne publications state, "Sensodyne contains strontium chloride which, by virtue of itsapparent biocolloidal binding and blocking actions, interrupts transmission of neural impulses--from tooth surfaces through dental tubes or connective tissue--to the dental pulp where pain isperceived. Sensodyne has also been shown to be an excellent choice for preventive home care.With good cleaning and foaming attributes, it is readily substituted as a routine replacement forpreviously used cosmetic tooth pastes." The other specialty dentifrice is "Chloresium". It works well as a typical routine dentifrice,and it contains chlorophyll, the natural ingredient used by nature in trees and plants as part of thenatural environmental "cleaning program." Chloresium has been recommended in the past,particularly for patients with stubborn halitosis (bad breath) conditions. Additional recommended items You may encounter some difficulty obtaining tooth drops, NF. (national formulary) fromyour local drugstore. If you can, discuss with your pharmacist your need for this preparation,which he should recognize as zinc oxide-eugenol. Zinc oxide is a white powder and eugenol acolorless liquid with the consistency of light engine oil. These two, when mixed together as instructed, will combine to form the material for atemporary filling (see Chapter Twelve). The eugenol is an obtundent, which means that it has abeneficial effect in "quieting" inflammation and helping to bring relief from toothache pain whenused as a temporary filling. A prescription is not required for zinc oxide-eugenol preparations, so if your druggist wishesto cooperate with you, this can be made available. At minimum, you should try to obtain theeugenol. If you cannot get zinc oxide, or if you prefer to use a premixed temporary fillingmaterial, ask your druggist to get you some "Cavit"; distributed by Premier Dental Products Co.,Norristown, PA 19401.* This preparation comes ready-to-use, with instructions, as a temporary filling. It does not1
  • 31. contain eugenol, and its manufacturer recommends that before using Cavit, the cavity be swabbedwith, either way, you should make an effort through druggists to obtain eugenol. If, for any reason, you cannot obtain eugenol or Cavit locally, write Oramedics.* WhileOramedics is not set up as a product retailer, the staff constantly monitors products available, oras new products come on the market...and sometimes people have been advised how to obtainproducts when they are not locally available. Hydraulic cleaning devices Perhaps the best known brand name for such devices is the "Water Pik", manufactured by adivision of Teledyne, Inc. The concept used involves pumping water, plain or with chemicalsadded, through the machine in such a way that impulses or bursts of water are delivered to theteeth through small nozzles at the end of a flexible tube. Incidentally, the Water Pik brand isspecifically endorsed by Oramedics. We discuss the use of these appliances more thoroughly in Chapters Nine and Ten, especiallyas related to prevention of gum disease in adults. By arrangement with Water Pik company, aspecial tip has been designed to Oramedics specifications for use in a hygienic approach to aid inthe correction of periodontosis. Electric tooth polishers These home care devices are a wand-like, hand-held device which when used properly, cangive you the ability to "shine" your teeth to a degree approaching the quality of prophylaxis(cleaning) done by dental hygienists. The wand, or handle, contains a small electric battery-driven motor (re-chargeable). Themotor drives a rotary-action cleaning head with a replaceable small rubber cup at the "businessend." This rubber or plastic cup is shaped to fit tooth surfaces and is flexible enough to conformto the shapes of various teeth while in use. The spinning rubber cup, in which the user deposits a small quantity of cleaning paste, is thenmoved over the exterior of the teeth to remove stains, plaque and calculus. (Complete removal ofcalculus will probably require a professional cleaning). Ordinarily, such devices come with anumber of color-coded, interchangeable heads, so that each family member has his or herpersonal device, using the same motor-handle. Note: In Chapter Ten, discussing the use of this device in your personal hygiene program,you will find a special mention of the potential for helping your child remain cavity-free throughevery-second week (not daily) use of the polisher. You might want to compare the cost of thisdevice against the cost of two or three sessions at the dentists office for fillings in teeth whichthat child will, naturally, ultimately lose when replaced by permanent teeth.1
  • 32. Electric toothbrushes Electric toothbrushes seem to be helpful, if only for one reason: There is reason to believethat children will brush longer, and on a more consistent schedule, with electric toothbrushes asopposed to the old-fashioned "one-arm power" brush. Perhaps this holds true for adults, as well.If this is true for you or for members of your family, this appliance might be a good investment. Aside from this, there is no reason to believe that you cant do equally as good a job with astandard (high quality) toothbrush, properly used. Special mirrors Inexpensive "dentists" mirrors are available in many drugstores; some of these mirrors havesmall, battery powered lights. Others provide a degree of magnification and illumination. Theability to see what you are doing...or missing...inside your mouth is important and your efforts toobtain a satisfactory mirror or mirrors can help contribute a great deal to your overall hygieneprogram. Once again: The mirror of choice with Oramedics doctors is the "Floxite"* mirror. There you have it: Two shopping lists; one of them including must items (A) and one of themwith convenience items (B). List A Toothbrushes Interdental stimulators Disclosing tablets Dental tape Toothpaste or powder Mouth rinse (optional) List B --Zinc oxide-eugenol and / or Cavit. --A hydraulic cleaning device such as a Water Pik or Ora-Jet* --An electric polishing device (Not a cheapie) --An electric toothbrush with personalized brushes --A special mirror or mirrors; preferably illuminated and capable of magnification Before ending this chapter and moving on to a discussion of medicines, lets be honest aboutsomething: Money. The items in list A... the necessities... cost less per family member than theaverage person is likely to spend this month on cosmetics or beverages. The items from list B are a bit more expensive, but the total cash outlay for these items, manyof which will last for years, is probably a lot less than youll spend on your automobile thismonth. Its a common misconception that the average American "cant afford good dental health."The items mentioned in this chapter, used properly, will virtually guarantee good dental health.Cant afford it? --When you think about it, how could anybody afford not to be "choosy" and buy the verybest available when it comes to oral hygiene products or devices? The cost, in relation to ultimate1
  • 33. savings, is one of todays best buys.Editors Note: While this book was written nearly twenty years ago and the facts remain as validtoday as they did then, the products mentioned in this book are no longer available by OramedicsInternational since 1983. OraMedia, however has and is making efforts to provide theseproducts and pick up where Oramedics left off. OraMedia also provides some products, such asTheraSol non-prescription anti microbial rinse, not available when this book was written.OraMedia also endorses the Ora-Jet 7500 irrigation device over the Water Pik, and althoughmany people may already own a Water Pik, we do provide the special cannulae tips for thatproduct as well. Oramedics Clean-Between dental tape is also no longer available and wesuggest Oral-Bs dental tape, available at most pharmacies or supermarkets.Please refer to the product list at the end of this book for more information on available products.1
  • 34. Chapter Seven - Oral self-help medicine The chemicals used in becoming dentally self sufficient generally fall into one of twocategories: There are those used for hygienic purposes, in the actual prevention of odontosis; andthere are those used to relieve problems and pain brought on by symptoms of existing or previousdisease. In Chapter Six we mentioned one tooth paste specifically: "Sensodyne". This is for use whenthe teeth, themselves, display a sensitivity to temperature or touch stimulus and thishypersensitivity tends to cause a person to avoid regular or effective brushing. The other formulation we discussed in that chapter was dentifrice or mouthwash containingfluoride. Are these beneficial? To answer that, lets repeat that federal law prohibits selling anypreparation for use in the mouth, which contains more than point zero five percent (.05%)fluoride. There is no longer any question whether this chemical is effective against odontosis. Thequestions seem to involve how effective, and what is the best method of using it? Any company manufacturing a toothpaste or rinse containing fluoride will cheerfully providestatistics on effectiveness. One such company (a rinse, in this case) reports a 50% reduction incavities in a two year study of 222 children, beginning at age 10, using a .05% sodium fluoriderinse daily, a 10 milliliter dose. The same rinse used on 434 children age 11 and 12 over a three-year study, resulted in a 36%caries reduction; the significant difference apparently the amount used (7.5 ml) and the "use time"--two minutes daily. Oramedics doesnt argue the figures of any such reports. There simply is no longer a questionabout the effect of fluoride on odontosis. Its a powerful weapon against disease, and has otherbeneficial properties also. In fact, fluoride seems to work no matter how we get it to the oral cavity: In pastes, in rinses,through the drinking water, by taking pills or painting it on the teeth or --you name it --it works. Whether it is proper to put it into drinking water when it is readily available in other forms,all elective with the user, is a philosophical question...not a medical question. Oramedics wishes only to point out that while all the research reports agree that fluoride hassome degree of effectiveness against cavities no matter how its used and in what concentration,there is no research claiming that it is 100% effective in concentrations available to the generalpublic. And therein lies the problem. If the public is led to think of fluoride-formula dentifrices orrinses or water supplies or pills as a panacea against odontosis, they are the victims of a gravemis-service. Fluoride is not a panacea. By itself, fluoride will probably not bring wholesale relieffrom this disease --certainly it wont do it in .05% concentrations --and therefore, if people thinkof it as "the answer" they are perhaps going to get slipshod in their own hygiene and remiss insupervision of their children. People who are enrolled in the Oramedics program ...either in the practice of an OramedicsFellow or through the mail... may be put on fluoride rinses at one time or another. Theconcentration may vary, depending upon the individual case after clinical testing and study oforal and medical history; in many cases the concentration will be at about a point two percent(.2% to .25%) level, or in difficult cases up to .5%. The rinse used by Oramedics ismanufactured to rigid specifications and is available (only with prescription) as Oramedics PhaseIII rinse. Every individual has different needs and so any discussion of fluoride rinsing must considerthis variety of applications. Generally speaking, however: When a persons saliva test count1
  • 35. stubbornly refuses to drop below 8,000 per mi., and there is reason to believe that person is doingall of his or her personal hygienic "exercises," Oramedics will sometimes prescribe use of .2% to.5% fluoride rinse for a specific term --for example, one month --used once or twice daily,depending on individual case conditions. After the germ count has been brought within tolerance, the habitual, frequent use of fluoriderinse in concentrations of more than the legal consumer maximum,.05%, is not recommended.For one thing: Fluoride, no matter how beneficial to our oral health when used properly, is adeadly poison if misused. What are the potential hazardous side effects of long-term,indiscriminate use? --We dont know; and Oramedics doesnt want to find out "the hard way," byadvocating unnecessary use of fluorides. For another thing: Although it may be beyond "reason" in purely scientific thinking, theres a"what if" involved in using fluoride: "What if lactobacillus acidophilus and or streptococcusmutans --or a mutated variant of either or both --developed an affinity for, or a resistance, tofluoride?" --Highly improbable; perhaps downright ridiculous... but there are a number of age-olddiseases now coming back strong, haunting the medical profession which, a few years back, usedantibiotics like a scattergun against infectious germs. Some of those mutated disease-bearersthrive on penicillin, now... Thus, Oramedics use of fluoride would be more comparable to the "rifle technique." We takeaim and fire, with a concentrated blast of fluoride rinse, intended to utterly destroy existingodontosis pathogens. We dont scattergun, hoping to maim or cripple some of them. We wantthem all --and then, when the germs no longer cause a saliva test above tolerance levels, we stopusing fluoride. It is very rare to have to resort to its use again, later; ordinarily the personscontinuing oral hygiene program is adequate to maintain a disease-free environment withoutmedical assistance. Should you use commercially available fluoride products? --Thats up to you. The facts areevident: Such preparations can and do bring some statistical relief from cavities. There is not ashred of evidence that daily use of .05% concentrations in rinses or dentifrices has anyharmful effect. If you are aware, and remain aware, that this by itself is only partially effectiveagainst odontosis... that you still have a personal responsibility to your own hygiene and that ofyour children... commercially prepared fluoride products then become largely a matter ofpersonal preference. Dentists may use still another approach involving fluoride: The topical application. In this, amuch higher percentile concentration of fluoride in paste or gel form is applied directly to theteeth. Again, statistics prove a beneficial effect. This may be offset by the infrequency orirregularity of the treatment and, of course, by the expense involved, since it requires an officecall.1
  • 36. Medicine in your kitchen Two substances have been handed down for generations as folk medicines: Baking soda andcommon table salt. Claims for the properties of these familiar chemicals range from the ridiculousto the sublime: Theyve probably been "known" to cure almost anything, at one time or another. In your oral health medicine cabinet, these two can be used for hygienic purposes as well asdental first aid. The first use, hygiene, simply has both soda and salt double as a dentifrice. As a youngster, you probably experimented at one time or another by mixing baking soda andvinegar. Remember the reaction? The solution bubbled and boiled and fitted: Something washappening. Apparently vinegar and soda are not overly compatible. Why is that? Well --vinegar isacidic, and soda is alkaline. Acid and alkali are at separate ends of a scale...they truly "dont getalong." In Chapter Five, you learned that part of the disease process of odontosis takes place whenthe germs ingest sugar and begin excreting acid. It is this acid which begins the insult to toothenamel which will become, eventually, a cavity. If you use soda as a dentifrice, you will no doubt create that "soda-vinegar" reaction; excepton a scale so small as to escape observance. In this, there arent any research figures we cansupply; no weighty documentation. It is, instead, plain commonsense. Soda and acid are notcompatible. Soda wont hurt your teeth and gums... it wont hurt you if you swallow a teaspoonful(makes you burp)... but it isnt going to do acid a whole lot of good when it comes in contact withit. Conversely: Acid will hurt you in the teeth and gums "--itll rot yer teeth." Salt is sodium chloride and it is a significant element of the physical makeup of the humanbody. The "saline solution" used in many medical applications is generally about point ninepercent (.9%) salt in water. It is used, for example, as a base solution for injections: It balancesthe osmotic action of the body fluids so the injection does not disturb the normal balance of waterinside the bodys cells at the area of the injection. Saline solution (salt water) in any concentration where the salt can be tasted will be ahypertonic solution: It will draw water from the cells of tissue bathed in it. A hypertoniccondition in the mouth will instantly and automatically cause the salivary glands to go intoovertime production. This is something to remember if you are frequently in places where wateris not available for "normal" tooth brushing. A dry mixture of soda and salt is not inconvenient totake along on a camping trip, for example. Using this "dentifrice" without water is easy: Themouths water fountains will provide more than enough. This capacity of salt --to act as a hypertonic and draw water (fluids) from tissues --should bekept in mind for another reason, which will be more fully discussed in the chapter on dental painand first aid. For now: When teeth "act up" and pain sets in, there is often (perhaps usually) abuildup of fluids in the area of the affected tooth. Wouldnt it make sense to use a "medicine"which helped reduce this fluid pressure? ...Hand me the salt, please --Im getting a toothache...1
  • 37. Pain relievers Most pain relievers require prescriptions, and for very good reason. Often they art: narcotic,or habit-forming; often they can cause harmful side effects. Of those available withoutprescription, the two most effective and least problematic are: Benzocaine: A topical analgesic (pain killer) for use in direct application to the affected area.Benzocaine, for example, is an ingredient of several lotions used for relief from pain and itchingof sunburn. Aspirin: An ingested analgesic which acts against pain only after it enters the bloodstreamthrough the digestive tract. Benzocaine is available in certain commercial preparations for toothache. One suchpreparation is trade-named "Dents Toothache Gum". Another typical over-the-counterpreparation, "Red Cross Toothache Drops", utilizes a different chemical, eugenol, to help relievedistress. Eugenol is not typically considered an analgesic, it is an obtundent. More about thischemical and its effect shortly. Aspirin is the generic name for acetylsalicylic acid USP (U.S. Pure grade). It is marketedunder a host of brand names and often is compounded with other ingredients usually intended tooffset the side effects of the aspirin itself. Aspirin is not, as many assume, a harmless drug;particularly if misused or taken in quantities above those recommended on the label. The person who seriously overdoses on aspirin may find himself with a buzzing or ringing inthe ears, and the sensation of dizziness. More than one person has been surprised upon sufficientaspirin overdose to find himself at a hospital emergency room, where his condition was not takenlightly by the attending physician. Severe acidosis is dangerous. Nor is aspirin "harmless" in small quantities, if used for prolonged periods. Cases of internalbleeding have been traced to prolonged use of as little as two or three aspirin tablets daily. Lossof a teaspoonful of blood daily would probably go without notice but in time it would producedangerous anemia. Aspirin works, and it works as a depressant of pain symptoms. It can also help in reduction ofinflammation, but this effect is not pronounced enough to be a major consideration in self-dentalcare applications. Aspirin does not correct the cause of the pain, nor will it work in any way otherthan by being swallowed and introduced naturally to the bloodstream. Most emphatically, aspirinis not a topical analgesic: It should never be used in direct contact with the source of pain such aspacked into a cavity. Chapter Thirteen tells more about why aspirin can be dangerous used in thisway. If aspirin, taken in recommended quantity, does not completely relieve the pain --whetherheadache, toothache, or you name it --it is quite likely that nothing short of a prescription item oranesthesia would bring relief. Increasing the aspirin dosage many times will not be much moreeffective as an analgesic, and the danger of acidosis becomes significant. The easiest way to manufacture, store, sell and administer aspirin may not be the best way foryou to use it. Obviously, the small, hard "aspirin tablet" is ideal for all of the above reasons,including administration when you consider that each tablet is a pre-measured and accurate unitof dosage. One other reason why tablet-form administration works well is that aspirin withoutadditives has a foul taste: Many people cannot dissolve an aspirin tablet in the mouth, or chew onone, without triggering a vomiting reflex --they either gag, or throw up, or both. However: If aspirin could be accurately measured as to dosage, then administered in solution,two things would happen: 1. The aspirin would be able to enter the bloodstream much, much faster; bringing reliefsooner than the same dosage in tablet form; and 2. The harmful side effects of the acid... damage to the tissues of the stomach... would be1
  • 38. greatly decreased. Thus, when you find yourself in a situation at home where you or a family member needs totake aspirin to offset dental pain, you can "concoct" your own remedy. Take the proper number ofaspirin tablets according to label instructions given by the manufacturer and crush them intopowder. A cup or dish and teaspoon makes a good "mortar and pestle" for this. Then dissolve the powder into a flavoring drink, which can be virtually anything to mask thetaste of the aspirin. The amount isnt important, so long as it isnt too much to comfortably drinkdown at one time. It would be better to avoid using a sugar-sweetened solution --there arenumerous prepared beverages available which are sweetened without sugar. It might be well toavoid using a citrus juice as the base for your mixture, since this would have the effect of addingmore acid. The objective is to get the aspirin into solution so as to disperse its acid effect instead ofconcentrating it in one area of the stomach lining as a tablet does; and to enhance absorptionthrough the stomach into the bloodstream, getting the aspirin on the job quicker... and, finally, tomake the solution palatable, so the user doesnt spit it out or gag or simply "lose it" throughbecoming sick to the stomach. Eugenol This chemical is a plant extract which the U.S. Pharmacopoeia has listed as eugenol, U.S.P. Itis usually available in well stocked drugstores and pharmacists will generally know what you aretalking about when you ask for eugenol to use in a cavity. Whether the particular drugstore stockscommercial preparations of eugenol will depend on whether dentists in his trade area buy throughhim, or directly from their own chemical and equipment suppliers. Eugenol is an obtundent; when applied directly to an inflamed nerve chamber it has theability to "quiet" the nerve and help reduce inflammation. It is not an analgesic --it doesnt specifically kill pain --but it can relieve the symptomaticcause of some pain, and, indirectly, bring relief. As mentioned earlier, eugenol is sometimes part of the composition of trademarked toothacheremedies. If you cant obtain eugenol itself from your drugstore, look for the over-the-countertoothache remedies and read the labels. If any of them have eugenol in them, the label will say so.It may not be unmixed, "straight" eugenol... but it will usually be a whole lot better than nothing. Eugenol should be used in a cavity as a preparation to, or part of the chemistry of, atemporary filling. When used as part of the compound itself, it must be mixed with a powderedsubstance: Zinc oxide This substance resembles powdered or confectioners sugar in texture and is a bit darker incolor. When mixed with eugenol it becomes putty-like in consistency and can be shaped, formedand packed into a cavity. Once there, the mixture hardens without shrinking. If properly packedinto a cavity, it will completely fill the hollow portion of the tooth. (More on the use of this andother temporary fillings in the chapter on dental first aid.) Commercially prepared temporary filling materials1
  • 39. In Chapter Six we discussed a product called "Cavit". This material has an advantage in thatit is already mixed; you simply snip the top off a small tube and use the contents. It hardens undersaliva and makes an acceptable temporary filling. It has a disadvantage in that it does notspecifically contain an obtundent ingredient (see eugenol, above). The advantages of this material can be employed, and the disadvantage overcome, by usingeugenol to swab the cavity preparatory to filling with "Cavit". Again, if eugenol is not available,use of a commercial toothache drop containing eugenol and, perhaps, Benzocaine, would beindicated prior to filling the tooth. Medicines that affect oral health Obviously, we are not going to be able to discuss each and every medication that has abearing on oral health. The human body is a closed system and anything which affects one part ofthe system can have side effects elsewhere in the system; sometimes good, sometimes bad. The few that most directly affect the everyday life of ordinary people and have a bearing onoral health are these: Stimulants, depressants, tranquilizers, diet pills, alcohol and vitamins.Taking them in order: Stimulants are part of everyday life. Coffee and some soft drinks, for example, containcaffeine; tea has a nearly identical substance called theine. It is an alkaloid drug usually identifiedas a "pickerupper," it is a stimulant. It also interferes with sleep, whether you want it to or not. Itis used sometimes in compounds with aspirin, because it dilates blood vessels and stimulates theheart, thereby making the aspirin available more quickly through the bloodstream. Stimulants are not particularly useful in oral health; nor are they particularly harmful. Onepoint worth considering: part of the home treatment for toothache is for the sufferer to remain asquiet as possible and reduce the "throb" of heartbeat. Stimulants, in such a case, work againstyou. Depressants obtainable over the counter have little relationship to oral health. When theycross over the borderline and become prescription tranquilizers, however, they can be bad foryou. Tranquilizers affect the production of saliva, sometimes seriously. If you are being treated fornervous tension or have a prescription tranquilizer for any reason, be sure you discuss thiscarefully with your druggist and doctor. Diet pills are frequently a form of amphetamine... the "speed so beloved of dope addicts.Again, these compounds can seriously --even dangerously --upset the chemical environment ofyour mouth. If you are taking such medicines, either legally for weight loss, or illegally for kicks--because they seem to speed you up and make you more effective --you may be in dental trouble.If youre legal, ask your doctor about this. If youre illegal...ask your pusher, perhaps --but beaware that you are seriously impairing your oral health. Of course, these chemicals are stimulants,but for the purposes of this book weve separated them from the more easily obtainable...and farless harmful...stimulants such as coffee or tea or soft drinks. Alcohol is a depressant and contains a high carbohydrate content; it is high in sugar. Inmoderation, alcohol is probably not overly bad for oral health. It has one side effect, however,which is the main reason people drink it: It tends to lower inhibitions; to make people forgetful,and generally promote a feeling of expansive wellbeing. In other words: Well get half in the bagtonight and to hell with brushing our teeth... In which case, of course, alcohol is bad for your oralhealth. Vitamins are necessary for general health. A well-rounded diet with adequate nutrition is allthats necessary to maintain oral health. In the young in particular, and in the case of pregnantwomen, the mineral intake is important; particularly in the case of calcium, the building block ofteeth.1
  • 40. By definition, a vitamin is something which the body cannot synthesize (manufacture), butmust recover in ready made form from the foods we eat. Vitamin C --ascorbic acid is a truevitamin: It cannot be produced in the body and comes from our foods, notably fruits, vegetables,rose hips, currants, and so on. When the system is lacking in vitamin C the connective tissues and small capillaries (tinyblood vessels) either do not form or begin to degrade. That is why lack of vitamin C was identified centuries ago as a disease called scurvy: Theblood loss and destruction of connective tissues was most apparent in the loss of teeth...theysimply fell out. Obviously, then, vitamin C is necessary for good oral health as well as overall whole-bodyhealth. The normal diet supplies plenty of vitamin C but if there is any question, it is available asa supplement and is quite economical. Most scientific evidence agrees that excess vitamin C issimply passed off harmlessly, so within reason there is little danger of overdose. One final point about vitamin C: It is not a vitamin to many animals in that they are able tosynthesize it internally, while humans cannot. Thus, milk obtained from cows is low in vitamin Csince a calf would not need it from this outside source. The milk of a human mother is muchhigher in vitamin C, because the human infant has no other source and cannot manufacture it. For mothers who choose not to breast-feed infants, some care should be taken that theformula for bottle feeding, whether a commercially prepared formula or home brew, has adequatevitamin C for the infant. Your oral medicine cabinet should also include something called, generically, dental paste,USP. You will probably find it difficult to locate a generic product and one of the best trademarked products is "Orabase". This can be purchased without a prescription (as "Orabase" withor without Benzocaine) or with a prescription as "Kenalog" in "Orabase". For oral health firstaid, the non-prescription variety is probably equally as beneficial as the one requiring aprescription. Chapter Twelve describes the use of Orabase for home treatment of lesions or cuts inside themouth, for example as relief from the herpes simplex virus lesion commonly called a canker sore.1
  • 41. Chapter Eight - Your personal oral health maintenance program In this and the following chapter we will discuss your personal contribution to a disease-free,relatively problem free oral health environment. This takes in much, much more than oralhygiene, although you should by now realize that hygiene is the cornerstone of any realisticapproach to oral health. Oral health maintenance, properly achieved, should help accomplish many things; theimportant ones being: We will dynamically reduce, and probably eliminate, cavities. We will achieve an environment which will not support periodontosis (advanced gum disorder). We will create a healthy gateway to the physical system, keeping in mind that the A.D.A. considers that a huge proportion of all disease and body disorder originates in the mouth. Obviously we will improve the cosmetic, the esthetic value of the mouth; thereby aiding in an overall self image, virtually a psychological necessity in our society. We will help prevent or at least reduce oral health problems such as tooth-grinding, misalignment, and others. In order to perform the necessary level of health maintenance activities, you will have toknow how to: Clean all tooth surfaces. Establish a regimen suitable to your lifestyle and time schedules, and stay with it. Keep alert: Obtain tests when in doubt, be on the lookout for any disease symptom, particularly in the young, and use everything at your disposal to constantly help monitor the environment in your mouth, or your childrens. Understand and use diet and nutrition to your oral health advantage. Make use of products and devices designed to enhance oral health care, to achieve maximum benefit and advantage.The elements of oral hygiene Essentially, oral hygiene can be summed up in one expression: Keep em clean! Hundreds ofseparate research projects have established beyond a doubt that clean teeth and gums dont getodontosis: Clean means healthy. A frame of reference is involved be careful how youunderstand that concept. If its scientifically proven that clean teeth dont get sick, how come so many people (98 outof 100) have odontosis? They cant all be slipshod in their oral hygiene, can they? No, of course not. However, so few people truly know how to care for their teeth adequatelythat their best efforts are simply not good enough. Even the few who have been told how, bydentists or through extensive self-research, have not been told why... and once again, motivationenters the picture. Human psychology being what it is, if a person is told how to do something, but not why; andespecially if he is not given any encouragement that his efforts will be truly productive, the1
  • 42. investment of time and attention becomes burdensome. Far too many Americans have been sold the concept that basic oral hygiene is this: Brushafter meals, use floss, avoid sweets, and see your dentist twice a year. Hardly anyone brushes after every meal. Unfortunately, society views tooth brushing assomething to be done in private. A recent article in a metropolitan newspaper, in a discussion ofetiquette, recommended in fact that using a toothpick in public was vulgar: The person should goto the rest room if he or she felt the need to "pick the teeth," so as not to offend others. What are you supposed to do, carry a tube of toothpaste and your brush around in your purse,looking for rest rooms? -What if you dont carry a purse? Picture an executive, male, dressed forthe days business, with a tube of Supershine and a toothbrush peeking out of his suit coat pocket.Incongruous? Childish? --Perhaps, but it makes the point: Until our social attitudes change withrespect to oral hygiene, we simply are not going to have, or create, opportunities to "brush aftermeals." If you can, its a good idea. If you "cant" --join the club. Using floss is another of those almost-good ideas. The proper use of dental floss has been thevery best individual hygiene element for more than 150 years. Three strikes against dental flosshave more or less taken it out of the game, as three strikes does to a baseball player: (1) Floss is not the best material for this use, tape is much better...but most people dont know that. (2) Most people have never even tried flossing; many who have tried it dont like it. (3) In all of the publicity generated in an attempt to get people to floss their teeth, very little is ever said about why, or what good it does. Without motivation, people wont usually do something they dont particularly like to do. The admonition to avoid sweets is downright asinine. In American diet, avoiding sweets isjust not possible. can avoid candy and reduce your intake of raw sugar, but to modifyyour diet enough to "avoid sweets" to the point where active odontosis went into remission, youdhave to almost literally starve. Youd hurt yourself more than youd hurt the odontosis germs. Finally: How about those semi-annual checkups? Do you faithfully visit a dentist every sixmonths? Probably not. Few people in our society do. If you do, youve probably discoveredduring those visits that there is additional evidence of disease since your last trip. What was done,then, to prevent it? Is there any way the dentist could have done something during your lastcheckup to ensure youd be free from disease damage at the next checkup? No. Dentists have no magic formula, no medicine and no equipment that can bring youfreedom from odontosis without your active, continuing participation. As it matter of fact, thosewho visit their dentist often have fewer teeth than those who avoid visiting dentists... The dentist cannot prevent odontosis without your help. You can prevent odontosis without adentists help. How is this done?1
  • 43. Brushing the teeth Professionals have disputed for years over the best way to brush the teeth. What is acceptedas normal this year may be swept away on the winds of professional fashion next year. Is it betterto brush with up and down strokes or with side to side strokes? Should you brush hard,vigorously --or would it be better to be gentle, to take it easy? It isnt altogether strange that most people have no really definite understanding of how tobrush the teeth; the profession that should be telling people how cant agree among themselves. Some preventive practitioners have learned that you can get peoples attention by tellingthem, after looking in their mouths, whether they are right or left-handed. Even though the personbelieves he or she has been genuinely faithful to do a thorough tooth brushing job, there willusually be more evidence of odontosis damage on the side of the mouth corresponding to thehand they principally use. Maybe all that proves is that its easier to reach the "off side" of the mouth than the side thatmatches the hand you use. We think it proves that people have the wrong frame of referenceabout tooth brushing: If they do a better job on one side of the mouth than the other, its obviousthat they are not doing the whole job adequately. In a study made in Minnesota, people were asked to brush their teeth in the office and to giveit their best effort. The people were not informed that the brushing would be timed. The testturned up a surprising fact: Only one out of every 40 or 50 people brushed for as long as one minute! Most peoplebrushed for 20 to 30 seconds and one standout person, who claimed to be an excellent andfaithful brusher, went at it so vigorously she was overheard in the adjacent room --for a total of15 seconds flat! When many people seem to spend about the same amount of time brushing their teeth, itfollows that there must be some common reason for that specific length of time to be "enough."Upon examination, youll learn that it takes between 20 and 30 seconds for your mouth to fill withfoam...saliva and dentifrice that its awkward and uncomfortable to continue brushing. Thenwhat? --Then you spit in the sink, rinse the brush, swish some mouthwash around in your mouthfor a few seconds...and youre done. Can you do an adequate brushing job in 20 or 30 seconds? Its virtually impossible. Question:When the mouth fills to an uncomfortable level, why not spit out the excess and keep onbrushing? Theres still plenty of dentifrice remaining. So: Adopt, if you will, a new frame ofreference. Tooth brushing is not timed by how long it takes to fill the mouth with foam. Its timedby when youve finished brushing the teeth. And how long is that? When youve developed a degree of familiarity with your newbrushing technique and are able to do it the same way time after time, the average excellent jobwill take you two minutes. In fact, its a good idea to actually time your tooth brushing so theresno tendency to rush it. Two minutes is not very long --unless youre brushing your teeth! Then,apparently, it "seems like forever." --Use a clock, please. The more difficult-to-reach teeth always get the least brushing care. Its not surprising thatthese "orphans" are the teeth that also suffer the most disease damage. Most people have littletrouble getting the visible (front) teeth clean. These are the teeth that make or break yourcosmetic appearance. This is social brushing, and it doesnt really do the job as far as diseaseprevention is concerned. Those teeth in back are more prone to odontosis then the front teeth. Byvirtue of shape alone, the back teeth can harbor more plaque and germs. Aside from this, the frontteeth are the "biters," and they typically will be cleaned while biting through foods.1
  • 44. One study indicates that the teeth in the under-brushed sectors receive less than 20% of thetotal brushing effort. The teeth that need it most get five times less attention than the ones whichneed it least. If you go to the full two-minute brushing regimen, youll find yourself almost automaticallygiving the danger zone more attention. It stands to reason that when youve done the front teeth,and the clock says you still have a minute and a half to go --youll be "looking" for something elseto brush. Good! ...Do the ones in back, now! There is no perfect set pattern for tooth brushing. The only thing you should understand isthat there are, for practical purposes, about eight areas you should concentrate on. Not in anyparticular order, you should brush so that you do one sector at a time; finish it, and then go on tothe next. These sectors are, more or less: The external front teeth, top and bottom, to the eye teeth. The external back teeth on one side of the mouth. The external back teeth on the other side of the mouth. (Give both sides the same attention: Dont let right-handedness cheat the health of your right side teeth, please... or vice-versa.) The internal surfaces of the front teeth. The internal surfaces of the back teeth on one side. The internal surfaces of the back teeth on the other side. The chewing surfaces of the teeth, both sides, top and bottom (This last might be considered two separate "zones," for instance, first the top teeth, then the bottom teeth.) The objective is to get all of these surfaces really clean. Aside from the dentifrice you use, orthe type of brush, theres only one way to guarantee that all tooth surfaces which can be cleanedwith a brush get a thorough going-over: You have to take each section one at a time and scrubuntil youve got them all. This can be done quite well in two minutes; it obviously cant beaccomplished in 20 or 30 seconds. Up and down, back and forth...or circles...whats the right way to brush the teeth? Again: Thishas been the subject of discussion since dentists first learned how to argue. You will find thatyour own habit patterns develop fairly naturally and anything which seems awkward or unwieldyto you will probably cause you to do a less thorough job. For those who want some suggestions: The brush is held at about a 45-degree angle to thegum line and moved gently back and forth. Use short strokes - remember, you are only trying toclean one or two teeth at a time. Change the angle slightly, move the brush handle in and out,toward and away from your face, as you brush, so that the bristles have a better chance to contactall of the curves and planes of the tooth surfaces.1
  • 45. Remember: You arent trying to do a "fast" job, or a "vigorous" job, or a "hard job ofscrubbing... just a thorough job. One final point: Toothbrushes wear out. There is objective data available which indicates thata well used toothbrush begins to lose efficiency after one month of service. How long your brush will last depends on how much use it gets and how good it was whennew. Naturally a better quality brush will outlast a cheapie. At any rate, before you can seenoticeable signs of wear, your toothbrush is not doing as good as it did when you bought it. How expensive can a new toothbrush every month or six weeks be! If this is within yourfinancial "comfort zone," a new (good) brush every month is an investment that can contributetoward freedom from disease --and that will save you a lot of money. Flossing or taping This is the vital element of oral hygiene; equal in importance, if not more important, thantooth brushing. Yet, time and again studies disclose that people simply do not use floss with anyregularity. Moreover, many people are not aware that there are different kinds of dental floss; thatthere is a product similar to floss (tape) which is superior to floss in many respects. Dentists and hygienists have known "forever" that the surfaces between teeth are the mostcritical disease areas. In the chapter dealing with the anatomy of the mouth, and again when wediscussed the process of odontosis, it was emphasized that this between-the-teeth space... so tightas far as we are concerned... is the size of New York City as far as germs are concerned. Keeping this in mind, recall that the beginning of odontosis is when germs excrete and formplaque; and then use that film for explosive colonization, creating more plaque. Many authoritiesagree, and research clearly indicates, that the most damaging effects of cariosis occur where thereare heavy layers of plaque. Remembering that "heavy" is a relative term, and that dangerousplaque accumulations can remain invisible or escape notice, we can understand why anyundisturbed plaque is a troublemaker. Brushing properly and regularly is generally adequate to prevent formation of plaque buildupon the outer surfaces of the teeth. Brushing cannot reach the plaque deposits between closely-spaced teeth. Teeth that are, in fact, touching each other as far as we are concerned will still havea microscopic space between them; germs can colonize there and your brush cannot get at them. What can get in these spaces and do a thorough cleaning job is floss or tape. Either will work:If you for some reason cannot get tape, use floss that is more universally available in drugstoresand supermarkets. The disadvantages of floss lie principally in its very fine diameter. It is threadlike, with mostwell known brands not even as heavy as common string. This makes it more difficult to handleand increases the likelihood of cutting gum tissue with it. Moreover, if it only contacts a smallsurface area at any one time, it takes longer to use or misses spots. These disadvantages are overcome by using dental tape which, while no "thicker" than floss,is wider: It is more like tape or ribbon than string-like; it is "flat" instead of "round." There areschools of thought which maintain that un-waxed floss or tape is better, others which proclaim themerit of waxed products . Oramedics Internationals product, Oramedics Clean Between*, is a waxed tape. Since theOramedics name does not appear on any floss, or on any un-waxed tape products, this obviouslyis the recommendation of Oramedics Fellows: Waxed dental tape --not exclusively CleanBetween, but something as similar as possible. Using tape (or floss) is simple, once you get the hang of it. About 18 inches is removed from1
  • 46. the container-dispenser, which will have a small cut-off device. The tape is wrapped around themiddle finger of each hand with the bulk of it on one hand or the other. About six inches (more orless) is left stretched between the hands. The tape is then brought to the surface of the teeth, between any two, and inserted into thespace between teeth with a gentle back-and-forth motion. Once the tape is between the teeth, thesides of both teeth are "buffed" from top to gum line. It is generally easier to stretch the tapeacross two un-busy fingers, using the middle fingers only as the reservoir for unused tape and totake up the part you have used. When working on the upper teeth, guide the tape across your thumbs; when working on thelower teeth, use the first finger of each hand. As you use the tape, unwrap one turn from the sidewhere you are storing it and wrap one turn on the side where you are taking up the used tape. How long does it take to tape the teeth? If you have a full set of teeth --32 of them --there areobviously 28 spaces between teeth. After you have gained confidence that you can tape your teethwithout clumsiness, it should take no more than five or six seconds to tape any one space. If ittook six seconds each for 28 spaces, thats 168 seconds...less than three minutes. How long does it take to shave? How long does it take to put on eye makeup? How long doesit take for a shower, or to shampoo the hair? Most people have no idea, in absolute, objective time, how long these things take. They takehowever long is necessary, because the person wants to do them. Three minutes to tape the teeth is only a "long time" when its something youd rather not do:A pain in the neck. We believe this is something people dont want to do because most people areconvinced it is a waste of time: Theres no way they can avoid dental disease. By now, you knowthats a lie. People dont tape their teeth because the teeth are just going to get dirty in there againtomorrow, anyway...whats the use? Why dont people feel that way about taking a bath, or caringfor the hair, or shaving? -Youre just going to get dirty or sweaty again tomorrow anyway, right? --People want to take care of themselves because if they dont, other people will notice andthats embarrassing! We are conditioned by society; it is drummed into us by our parents thathygiene is a necessary social function first, and a health function second. In other words, people dont tape their teeth because nobody will know whether they did ordidnt ...they can get away with being slipshod in this department in a way they could nevermanage with other personal hygiene. Were not asking you to tape your teeth --to "clean between" --for social reasons. Youreright: Nobody will know tomorrow whether you did it tonight, or not... unless they get closeenough to smell your breath. Were asking you to realize that your oral health hinges on whetheryou do this or not. If you do it, and do it right, it will save you pain, money, embarrassment, timeand health. Maybe nobody else will know...but you will.1
  • 47. Disclosing tablets If ever there was a secret weapon in the war on odontosis, these little tablets would be anexcellent candidate for that title. Disclosing tablets are so simple, so inexpensive, and sofoolproof theyre almost hard to believe. All they are, no matter who makes them or sells them, is compressed food dye in some kindof base. They work on an amazingly simple principle: They cannot stain clean enamel; theyalways stain plaque ...even invisible plaque. If you were to chew a tablet, swish it around, spit out the excess and then look in the mirrorbefore brushing your teeth, youd think you were looking at something off the late night TVhorror show. Any plaque in your mouth would be stained a shocking red. Rinsing your mouthvigorously with water might reduce the paint job somewhat, but not enough so you were "back tonormal." The use of disclosing tablets is apparent. After brushing and taping between the teeth, a tabletis chewed and swished through the teeth. After you spit out the excess, one look in the mirror willinstantly spot any areas of plaque which you missed in your cleaning program. To get rid of thestains you simply re-brush those areas, or use tape if its between teeth. The stain goes away...andso does the plaque. This virtually foolproof method of checking your thoroughness is not "kid stuff" for adultswho are sincere in their efforts to prevent oral disease. Especially for those who are trying tochange frames of reference...from a former slipshod hygiene to a new, effective system...thedisclosing tablet is extremely helpful. It can be "kid stuff," however, when there are children involved. Its a little bit more difficultto motivate kids; they dont respond to technical information and arent overly concerned aboutwhats going to happen to their mouths in 15 or 20 years down the road. Getting those little rascals to brush properly and use tape is more of an exercise in appliedbehavioral psychology than in "telling it like it is." When you consider that one of todays mosteffective educators is the use of fun and games such as TVs famous Sesame Street program, theuse of the disclosing tablet becomes apparent. The kids will think youre just having fun with them, helping them make "monster faces" ateach other and in the mirror. Being able to paint the inside of the mouth a ghastly red is fun! In the meantime, you can be planting the seeds of oral health knowledge and technicalexpertise that will help guarantee a lifetime of oral health for your children. Inter-dental stimulators One of the success symbols which is disappearing from the American social scene is thesolid-gold toothpick. Executives who had it made in yesteryear frequently displayed their positionin life by digging this status symbol from the vest pocket after a meal and going to work on thefood stuck in their teeth. As far as oral health is concerned, the idea is "solid gold," and it doesnt particularly matterwhat the toothpick is made of or how its flavored. Inter-dental stimulators can be wood orplastic; flavored, colored or "natural." It makes no difference. What they do, and what you dowith them, is what counts. The inter-dental stimulator is a toothpick on one end (its pointed) and usually a flat blade orpaddle at the other. It can be conveniently carried in pocket or purse... one or a packet... and isusually disposable. As with most appliances for oral health maintenance, the cost is so small as tobe insignificant in comparison to the benefits.1
  • 48. When you cant carry a brush or dentifrice, or when for some reason you cant "stash" theseitems in your desk or the office restroom, the inter-dental stimulator can take the place of"brushing after meals." It may not be quite as effective as a complete brushing and taping, but it isa whole lot better than nothing. It can be done in a restroom, as you drive a car, as you ride anelevator... there are many private or semiprivate minutes throughout your day... or it can be doneright in front of people, if you begin to lose your inhibitions about taking care of your oral healthwhere others can see you. Using the inter-dental stimulator is simplicity itself. You simply hold it by the flattenedportion, between the thumb and finger; however it seems most comfortable and least awkward.The tip is inserted between the teeth at an angle away from the gums (more or less 45 degrees),and then gently moved in and out between adjacent teeth. Do this four, or five times, then moveon to the next space. The flat, or paddle, end of the stimulator may be used to gently scrape the outer surfaces ofthe teeth, removing or disrupting any plaque which may have begun forming. One final point about inter-dental stimulators: If you happen to run out of them or leave thehouse and forget to put them in your pocket or purse... pick up some wooden toothpicks on yourway out of the restaurant. Even a device as common and humble as a toothpick becomes an allyin our war against odontosis, once we change another frame of reference: The toothpick is muchmore than something to remove debris from between one or two pairs of teeth... it is, whennothing else is available, a portable back-up device for the toothbrush and dental tape. Mouth rinses Mouth rinsing after a full session of brushing and taping and disclosing is a good idea. Youwill have loosened up debris and scattered thousands of germs during your hygienic session; therewill be remnants of the disclosing dye and some dentifrice floating around in your mouth.Particularly in the case of marginal or poor initial oral health, there may be light bleeding fromsome gum surfaces. All in all, this mixture is not one youd be comfortable with; and there is no reason for you tonot rinse it out. If you wish to use a commercially available rinse, go ahead. These containflavoring which will leave you with a pleasant after-taste (important especially where children areinvolved: the "reward system" for doing a good job). Many commercial preparations contain an astringent that tends to cause a slight shrinkageand drying of surface membranes, perhaps a help in the case of gum tissue which is insultedduring the brushing and taping process. Some preparations contain fluoride in weak concentration and these have been scientificallyproven to be of some value against cavities. In addition, fluoride is known to enhance the naturalre-calcification process by which nature actually heals very early cavity damage and continuallyreplaces tooth enamel. Fluoride bonds atomically, through ion exchange, with the molecularstructure of the enamel. In any case: There is no scientific research at present which indicates thatuse of fluoride rinses in .05% concentrations is harmful; there is a good deal of evidence that ithas decided advantages. Oramedics Phase III* mouth rinse has a much stronger concentration of fluoride and thereforemust be prescribed and used under a doctors supervision. This rinse is used only for a specifiedterm (for example, one month) and the times-per-day of use, and concentration of fluoride, isbased on that individuals clinical reports. *Editors Note: The Phase III rinse is no longer available, although we do have anexcellent over-the-counter rinse called TheraSol that we highly recommend. TheraSol is ananti-microbial rinse that will actually kill off damaging microbes and does contain a safeamount of fluoride beneficial for remineralization.1
  • 49. Another excellent mouth rinse is a home-brew mixture: A teaspoon of baking soda and ateaspoon of salt in one cup of water will give you a rinse of genuine value. The salt will helpdraw fluids from the tissues while it stimulates saliva production. The soda will react against anyacid present in the mouth while it helps remove any odor. The combination is not an unpleasanttaste... just a bit "different" and one easy to become familiar with. If you cant use any kind of rinse because of your circumstances --in a car, on a bus, in anoffice or whatever --you can still do a fairly thorough job of rinsing your mouth simply byswishing natures own mouth rinse (saliva) through your teeth. If you are for any reason unable tospit, dont worry about it --swallow. Why not? You swallow saliva all day and night, naturallyand without even noticing it. It is part of the automatic natural oral hygiene system and it will goon whether you like it or not. So...whats the difference, whether you do it unconsciously,automatically...or "on purpose," because youre in a situation where you cant spit? Appliances The three most common oral hygiene appliances are the electric toothbrush, the home toothpolisher, and the hydraulic irrigation device. All three are recommended by Oramedics, especiallythe polisher and irrigation appliances. In the next chapter we will discuss very specific uses forthe tooth polisher as an advantage for your childrens health; and the irrigator as an advantage forolder people whose problems tend to be gum disorders more than cavities. The electric toothbrush probably cannot do a better job than the old-fashioned ArmstrongBrush... the one-arm power toothbrush... but that holds true only if the toothbrush is usedproperly, for long enough, to actually complete the job. The electric toothbrush obviously makesmany more strokes per minute than you are capable of with your hand and arm. It just makessense that you will do more brushing in two minutes with an electric brush than you will with ahand brush. The question is whether you will do more effective brushing. If the electric brush isonly used in the comfort zone... the outer top and bottom front teeth... it is no better for you than ahand brush. An advantage, with children, is that they tend to want to brush more with an electric than ahand brush because the electric brush is fun to use. Theres a psychological disadvantage, both foradults and children: What if you or the kids become so accustomed to the electric brush youforget, or never learn, how to properly use a hand brush? If you wish to use electrics, you owe it to yourself and your children to have on hand the old-fashioned Armstrongs for every family member... and, from time to time, conduct "toothbrushdrills" with the family to ensure that theyll know how to use the hand brush when, as, and if theycant use the electric. The electric tooth polisher is called a prophylaxis device --because thats what dentists andhygienists call a thorough tooth cleaning: Prophylaxis. This device was described in the chapteron materials. What it will do for you and the family is to allow you to give your teeth a near-professional "shine" whenever you want to, at home and without expense other than the initialpurchase. Theres no question but that the principal benefit of this device is cosmetic. You can do ahygienic cleaning without "polishing" your teeth. Even at that, the advantages are still perhapsworth the investment. So many of us will continue to place a premium on how our teeth look --asopposed to how they feel and their actual health status --that the psychological advantages of theprophy machine are obvious. For families with teenage children, this can help make all the difference in the world as to thekids attitude toward a total oral hygiene program. In their world, the social benefits play a majorrole. As they learn to function in interpersonal relationships at school... going through the1
  • 50. popularity contests, the girl/boy relationships... anything which enhances their cosmeticappearance is going to contribute to their psychological wellbeing. If that, in turn, helps instilllifetime oral health principles into their habit cant be a bad idea. Another use of this device relates to the oral health of children between the ages,approximately, of one year to age nine or ten. During this span the child will have its "babyteeth," later undergoing a transition to permanent teeth. In the next chapter, well discuss use ofthe prophy machine as a parent’s method of helping to reduce odontosis activity in the cavityprone years. Since this is the age group which is most difficult to entice or motivate regardingeffective oral hygiene, having a twice-monthly method of parental "insurance" care may besomething of interest to you. Oral irrigators are interesting appliances. Millions of Americans use them daily although theyare relatively new on the self-care scene. As more people become aware of the advantages ofthese machines, we think they will become even more popular. In essence, the oral irrigator is adevice which has a water-holding tank, a pump, and some method of interrupting the flow ofwater so it is delivered in "bursts" or pulses. The better models are constructed so that thepressure is variable from soft to quite firm in impact. This water is delivered to the mouth througha length of plastic hose and, finally, a nozzle tip, shaped for convenient use inside the mouth. The jet of water, coming in bursts, does a remarkable job of cleaning between teeth, aroundand under bridges and braces, and even reaches into cavities. While the machine is not intendedto be a replacement for brushing and taping, it is an excellent follow up for these and couldprobably be a near-acceptable substitute from time to time if need arose. Teledyne corporations brand of irrigation device, the Water Pik, is excellent. OramedicsInternational worked with the Water Pik people to develop specially made tips to fit theirmachine. These tips are used as part of the Oramedics approach to self-treatment ofperiodontosis; more on this in the next chapter. How do you use an irrigator? --Fill the tank, put the tip in your mouth, and turn it on. Followthe manufacturers advice if the machine has variable pressure: They are capable of delivering a"punch" that would have little or no ill effect in a healthy mouth...but could cause bleeding andproblems in a mouth with severe odontosis symptoms. When the water begins jetting through the tip, lean over the sink with your mouth slightlyopen, let the excess water simply run out into the sink, and... hose out your mouth: Skin, tongue,teeth, between the teeth, at the gum line, below the gum line...the works. Some people, after usingsuch a device for the first time, have remarked that their mouth never before felt so completelyclean. One last thought about irrigators: Some of them are made so that you can use the small waterreservoir to contain a mixture of water and powdered ingredients which, when blended, become amouth rinse. Using this feature will give you the final step in your cleaning job and your mouthrinsing all at once. Whats also good about it is that, when and if you run out of the little packetsof rinse chemicals, all you have to do is step into the kitchen for a teaspoonful of soda and one ofsalt, and youre back in business.1
  • 51. A combination of ingredients There we have the ingredients of oral hygiene --your personal oral health maintenanceprogram. Recapping them, we have tooth brushing (manually or electrically), taping (or, if needbe, flossing), using inter-dental stimulators (or toothpicks), disclosing (checking) and rinsing;with additional use of tooth polishers (prophylaxis machines) and irrigators as an option.When do you do all of these things? --Theres nothing wrong with brushing after every meal, and if you can, you should. Thinkcarefully, after throwing out your old frames of reference, about all of the times and places duringthe day when you could spend two minutes with a brush, without disrupting your schedule. Onething you will discover is that as your oral health improves, you will enjoy the clean-tasting,healthy "glow" of your mouth to the point that caring for it ceases to be a burden --Youll want todo it more often. If, however, you cant brush after meals, all the evidence of research together with thousandsof case history experiences has demonstrated that one thorough cleaning daily is enough to ensurefreedom from odontosis for most people. In an earlier chapter we discussed the beneficial role saliva plays in the oral environment; andhow the flow of this natural disease fighter decreases during sleep. Also, the tendency for mouthbreathing while sleeping further acts to dry out the mouth. During the hours when the naturalcleaning and rejuvenating processes are most dormant is the time when odontosis germs are busybuilding colonies. Not that they ever rest, as far as disease is concerned --but the mouth is perhapsmost vulnerable while we are resting. Therefore, it stands to reason that your efforts in hygiene should be concentrated at some timejust before retiring. There are other good reasons for selecting just before bedtime for your majorhygienic approaches: Usually all of the snacking is done by this time, so there wont be additionalgerm-food added after the oral cleanup. This time is also the most free from distraction; and it is a time when you can have thepersonal privacy most of us seem to prefer; whether showering, shaving, or caring for the teeth. It makes little difference whether you brush first, then tape, or vice-versa. One point worthconsidering is that you can use the tape --especially after youve "gotten the hang of it" -without amirror. This means you could easily use the tape while finishing up a TV program beforebedtime... or while reading a book (maybe this would take some practice)... or at the end-of-dayconversation with your spouse. Why not? One of you uses the tape while the other talks for a while; then switch roles. Notonly would you be able to take time to do a thorough job, you just might discover that thisimproves your capacity to listen to each other. For sure, you wont interrupt while using tape: Onething you cant do at the same time is talk intelligibly. Humor aside, find the time during the evening after youre done snacking or drinking to tapethe teeth thoroughly. Give it an honest three, four or five minutes... whatever it takes to makeseveral passes between each tooth. Brush the teeth, for at least two minutes. Pay attention to what youre doing so that youresure you cover every surface of every tooth. At first, and from time to time after youve become more expert at brushing and taping, use adisclosing tablet to make sure you got all the plaque from the teeth...particularly from the surfacesbetween teeth. Follow this with a final rinse --use your oral irrigator, if you have one --and then "hit thesack." The feel and taste in your mouth as you drift off to sleep... and again when you first wakeup... will make it all worth while to begin with; freedom from disease makes it worthwhile for a1
  • 52. lifetime.1
  • 53. Chapter Nine - Special-purpose hygiene methods Oral health maintenance approaches differ with age, and for good reason. In the infantthrough very young adult (teen) years the most significant problem will be cavities (cariosis). Thechild is less open to regimentation of any sort; motivation is difficult and forming hygiene habitscan be a real chore for parents. Sometime in the late teens the emphasis begins a subtle shift: Cavities begin to appear lessfrequently, often lulling people into the belief that odontosis has been overcome. At this "dentalhealth middle age," the person begins his battle with gum disorders: gingivosis and odontosis. As the person gets into full dental adulthood, on an average sometime around age 30 plus orminus several years, gum disorders become the major problem. There is another kind of problemassociated with older people, also: These folks often have some amount of mechanical dentistryin their mouths. This can be bridgework, partials... whatever, and such items create a specialrequirement for hygiene maintenance. This is the case, also, with the young people who wearorthodontic appliances (braces). The preceding chapter was a general discussion of the basics oforal health maintenance... the "minimum daily requirement," so to speak, for a disease-free oralenvironment. This chapter will address specific problems... and some solutions... for people in various agegroups. We will discuss the general oral health of these age groups, as well as some difficultiesexperienced by those with special needs. In this chapter: Protect the Precious The critical year from birth to age one. The Trying Years Children from one through four. The Transition Years Youth four through twelve. Your "Permanent" Teeth Teenage through young adult. For a Lifetime Young middle-age onward. Watch those Appliances For those with braces, bridges, etc. Perio-Dont-Itis Dont suffer from periodontitis. Protect the Precious1
  • 54. If you asked someone when he thought disease first begins in the human mouth, hedprobably assume sometime after four years of age... when there are some teeth in the mouth forthe germs to play with. Thats a woefully incorrect frame of reference. Statistics indicate that atleast half of all two-year-olds have evidence of tooth decay. When does odontosis actually start? Knowing that this disease is caused by germs, it islogical to expect that the process begins well in advance of any visible symptom, decay. In anewborn infant the mouth is, for all practical purposes, essentially sterile. Somehow, before thefirst teeth appear, this sterile environment is invaded by strep mutans and lacto germs. We believe the most critical year in the dental health lifetime is the year from birth to ageone. During this time the mouth goes from safe (sterile) to condition red (many thousands ofgerms per milliliter of saliva). The germs which cause odontosis are ubiquitous --they seem to be everywhere in theenvironment. Its doubtful that we will ever completely avoid contact with them. However, itmakes a lot of sense to avoid deliberate contact; and even more sense to do something tocounterattack... rather than just sit back and let it happen. Basically, there are four areas of infant oral health the parent can control: Dont introducegerms... dont feed the germs... keep the environment clean ... and use medication. Nutrition is vital to the infant, both for whole body health and oral health. There are manyauthorities on proper diet for infants: We only want to make two points regarding your babysdiet. First: Lighten up on the sugar, please. Many prepared formulas have excess sugar; as domany canned baby food products on the market. The taste for sweets is created at a very youngage; statistics show that the average person now consumes 120 pounds of sugar yearly. Thepioneer consumed only 10 pounds. Is a tenfold increase really necessary? Remember: Odontosis pathogens eat sugar; it is one of the bugs basic dietary requirements.Feeding your baby with an over-sweet bottle, or baby food, actually bathes those germs in the dietthey love the most. The growth of these bacteria can be explosive --exponential --in an oralenvironment rich in food-sugar. A common error mothers make is to put the baby to bed with a bottle as a "pacifier." Thechild falls quietly asleep with its mouth coated with milk, juice or some other highly sweetenedliquid. The environment in the mouth becomes a bacteria-generator... an incubator... providing aperfect setting for high levels of decay-producing bacteria before the teeth ever appear. From themoment the teeth begin to erupt through the gum they are exposed to an extremely hostileenvironment, often leading to cavities before the infant really gets a chance to "use" his teeth forany length of time. Another mistake, and a critical one, comes just before the child is fed "baby food." Prior tothis, when mama wants to test the temperature of babys formula before feeding a bottle, sheshakes a few drops onto her inner elbow where the nerves are sensitive enough to check thetemperature. Now, for some reason, thats no longer good enough. Instead, she dips babys spoon into thefood and tastes it herself to check temperature... then she puts that same spoonful of food intobabys mouth. Maybe the infant isnt all that interested in todays menu, so mama --hoping to "con" the kidinto eating --takes a bite herself, saying, "ummmm --good!" She cleans the spoon so the baby willsee how much mama liked the stuff. Okay...and every time she does that, she very probably inoculates the baby with germs fromher own mouth. Now, she wouldnt dream of doing that if she had a cold or some other problemshe might pass along to the infant. Why on earth is it wrong to give your child a cold, but okay togive it bad teeth? Oramedics, as you know by now, is very conservative in its endorsement of fluorides forinternal use. Oramedics Fellows will prescribe fluoride tablets or fluoride-containing vitamin1
  • 55. formulas for infants, but only on a case-by-case basis, and only after careful consultation with thechilds parents. For the infant from birth to age one, it is probably very beneficial to include traces of fluoridein the diet. This can be through public fluoridation of the water supply, or through speciallyformulated nursing supplements, or baby vitamins. In this instance, if you have serious questionsabout ingested fluorides, you may want to discuss it with someone in the health care field. It isprovably beneficial; nobody --yet --has proved that there is danger in ingesting fluorides inconcentrations of one part per million. In this case, the baby is yours; so the decision is yours. Before the babys teeth come in, the parent should make it a habit to swab out the childsmouth after each feeding and most definitely before any lengthy sleep. A simple tool for this jobis the ordinary two inch square gauze pad available at any drugstore. There is a product in limitedavailability, in some drugstores, called the "Toothette". This is a small, sponge-like swab on acardboard "stick," much like a small sucker. If you can obtain some Toothettes, they are ideal forinfant hygiene. When babys teeth arrive you should begin brushing them after meals and before bed. Use asmall, soft-bristled brush designed especially for infants. When the spacing of the teeth is suchthat the brush can no longer guarantee a thorough cleaning on all surfaces, its time to begin usingdental tape. Daily, preferably before bedtime, you can sit with the babys head on your lap; with a lightshining from over your shoulder. Starting with the farthest tooth back on one side, work your wayaround the mouth with the tape in a gentle back-and-forth motion, as if you were gently polishingshoes. Continue until youve cleaned in the spaces between each tooth, top and bottom. Protect the precious...and for a lifetime, you will have given your baby one of natures mostimportant gifts: Oral health. Psychologists today are, more and more, delving into the likelihoodthat many habit patterns, many elements of lifestyle, are begun in earliest infancy. To the infant,there is probably nothing in the world more comfortable, trustworthy, more pleasant, than thesights and sounds and feelings of mama. Think what an impact this may have on your childsfuture acceptance of oral hygiene! If the babys growing, developing relationship with the world around it includes... almostfrom birth... pleasant sensations connected with oral hygiene, it perhaps could produce deep,hidden gratification motives that will be "stroked" in later years when the child (and adult!) takescare of his or her oral hygiene. For virtually zero dollar investment and remarkably little time and effort you cansubstantially decrease the infants exposure to odontosis, while creating a solid foundation forfuture oral health care. So, during that first year... protect the precious! The trying years As your child grows through years one to four, these will be the trying years in many ways.Now the infant is mobile; one moment in the kitchen, the next --Gone! His curiosity is unendingand nothing is safe from those tiny fingers... which, unfortunately, more often than not will "test"anything they grasp by putting it in the mouth. Exasperating? --You bet! Supervision is the name of this game and mothers in particularshortly grow accustomed to the constant attention the child requires. She becomes an expert incleaning noses and bottoms, administering baths and shampooing hair. Very few mothers are negligent in these tasks, simply because they love the infant and thatsthe way nature planned it. The human takes longer to develop from helpless to self sufficient thanalmost any other resident of the earth. And yet, these same non-negligent mothers practically ignore the childs oral health and1
  • 56. hygiene. Why? --Probably because nobody ever told them this is a vital, essential part of parentalcare. Frame of reference, again: "Theres nothing you can do about oral health except hope;"while its perfectly natural to be concerned about baths, exercise, nutrition... On the contrary, there is a great deal you can do about oral health during the trying years.What not to do is wait until the child is about two years old, when ordinarily all 20 baby teeth arein place. By the time all 20 teeth have arrived, over half of all American children already have cavitiesand tooth decay. It is downright unfair to expect a child under two to be adept... even to care... when it comesto oral hygiene. They are just not ready for it. Given that half the babies born this month will have"bad teeth" within the next two years, who should be responsible? Helping the older infant care for his hygiene is really just an extension of the care begunduring the first year. Now, however, its possible that other family members can be pressed intoservice. In fact, it is distinctly to your advantage if older brothers and sisters can become part ofthe team, caring for the child. This vastly reinforces their own motivation to care for personalhygiene. Using the position described in protect the precious, with the toddler lying across your lapand a light behind you, gently brush and tape the mouth. Brushing should be done after mealswhenever possible; complete brushing and taping should be done preparatory to bedtime. Individual children will develop at a different pace, and there is no set time when the childwill begin wanting to try helping himself. Just as youngsters sooner or later want to take overtheir own hygiene in the bathtub; they will also attempt to strike out on their own with oralhygiene. The similarity doesnt end there: When your youngster first begins trying to bathe, youlet him or her... but you stand by to supervise, to teach, to encourage and to "finish up" what thechild did incorrectly. It is no different with brushing and taping. If the child shows an interest, super! By all means,encourage him or her to begin caring for himself... but dont just turn your back, thinking, "Thankheaven thats in the past!" Stay with the child until habits develop correctly, affording a lifetimeof attitude and aptitude that will result in good health. While brushing and taping, or supervising the childs efforts, be on the lookout for brownishcolored spots, discoloration or any other evidence of "problems" with the teeth. If you see thingsthat concern you; which you suspect may be early cavity activity, it would be a good idea to havethe childs saliva tested. If youve cared for the child from birth through age two as outlinedabove, there shouldnt be any odontosis. A saliva test will verify the presence or absence ofdisease-causing germs and, if there is some previously unknown condition or problem, the testwill act as a warning signal. The transition years From age four to twelve your child undergoes massive changes --the transition years --frominfancy to the beginnings of adulthood. There are physiological changes and psychologicalchanges... the person is part baby and part "grown up." For example, at one point during thisperiod there will be 52 teeth competing for space in that little mouth! It is a transition in yet another way: During this time, responsibility for, and performance of,oral health maintenance will shift from parent to child. This should be a gradual thing, so that thetransition is made smoothly. Now perhaps more than ever you will be guiding and teaching andmotivating the child in a way that will directly affect the remainder of his or her lifetime. The practice of brushing after meals and especially of brushing and taping before bed should1
  • 57. continue without letup. We want this habit so deeply ingrained in this youngster that it simplybecomes part of his or her second nature. Now another element is added: Disclosing tablets. Thepreceding chapter explained how these work and mentioned the motivating power they have uponyoung people. For your purposes, they also serve as an excellent spot check on the childs developing skillsand will almost immediately indicate any developing lack of interest or loss of skill. The first permanent teeth to appear in the mouth will be the six year molars, sometimes calledthe first permanent molars. They grow into the mouth immediately behind the existing baby teeth.Often parents mistake these for still more baby teeth, because their eruption is not associated withany loss of earlier teeth. Instead, these teeth grow into place somewhat later than the baby teeth,using available space behind the real baby teeth. Now there are 24 teeth visible in the mouth; 20 of them baby teeth and the four larger teethfurthest in the back, which are permanent. Of these, the 20 baby teeth will eventually exfoliate --theyll fall out or come loose and be easily pulled out. It is important that you make the distinctionbetween these teeth. Many parents have been more or less unconcerned over decay or damage tothe six-year molars because they mistakenly believed theyd be replaced like the other baby teeth.Not so: The molars should --and can last for a lifetime. Theyd better... there wont be any naturalreplacements for them. About this same time the front baby teeth will begin to loosen. Permanent teeth erupting frombelow usually cause the roots of baby teeth to resorb (become naturally dissolved), causing themto either fall out or become so loose they can be taken out with the fingers. It is important to know that in the eruption of the front teeth, particularly the lower ones, thepermanent teeth often tend to grow in behind existing baby teeth. This sometimes concernsparents because the permanent teeth seem to be coming in crooked or misplaced. Generallyspeaking, this is not something to cause alarm: The baby teeth normally come out when naturegets ready for them to come out, making space for the permanent teeth to grow forward intoproper position. This is the time of life hall marked by the toothless, awkward grin; its theme song, All I wantfor Christmas is my two front teeth. This is the most evident phase of the transition years, andshortly it is over as the permanent teeth take their places up front. Now the youngster has eight permanent front teeth... four on top and four below... and fourpermanent six year molars; one in each quadrant in the back. Nestled between these permanentteeth are three baby teeth in each quadrant; so that the youngster of 8, 9 or 10 will have 24 teeth,split right down the middle between 12 permanent and 12 baby teeth. During the next four or five years... generally, through about age 12... the remaining babyteeth will slowly loosen up and come out to make way for the full complement of permanentteeth. During this time the baby teeth can play host to disease problems such as cavities, and thisis particularly dangerous when we remember that half of the teeth in that mouth are not babyteeth. It is far too easy to adopt the attitude that since the child will lose the baby teeth anyway...soon, we need not be overly concerned about developing problems in those teeth. This is a serious mistake, because any disease which is active in the baby teeth can spreadand affect the newly erupting permanent teeth. When diseased baby teeth are shed, all that goeswith them is disease symptoms; The germs will remain behind to haunt the replacement teeth.Were talking about transition years --and the one thing we must avoid is simply allowingodontosis to make the transition from temporary teeth to permanent teeth. The child will have its first set of teeth for only a few years; the next set is the only one naturewill issue the youngster for the rest of his days. About halfway through the transition years, depending on the childs own developmentalpace, he or she will begin to take on more personal responsibility for oral health maintenance.1
  • 58. Remember, however, that this is a transitional phase; the responsibility remains with the parentsor older family members until the developing child is fully capable of accepting it. The child willdo more and more of the performing, but the checking... making sure... is up to mom and dad,sister or brother. One excellent method is to select a day of the week when evening activities are generallyquiet and relaxed --perhaps a Sunday evening, for example --and make that "oral health eveningfor the entire family. Family participation in such a weekly event is an excellent way to make oral healthmaintenance an integral and important element of family togetherness. This will contributeheavily toward creating lifetime good habits in the youngsters... and its not an all-bad way ofhelping mom and dad develop a new set of habits to replace the bad ones they learned earlier inlife. Thus the older family members spot-check during the week as the developing youngster goesthrough nightly hygiene: "Okay, Cowboy...lets see how you use that tape, now..." And then, onthe "family night," its time for disclosing tablets and family show-and-tell. How well did thechild do throughout the week? The once-weekly "hygiene drill" with its disclosing tablet timewill tell the story. If the youngster is not passing the weekly checkpoints with flying colors, its high time for theolder family members to step in and reinforce either motivation or technique... attitude oraptitude... until the child once again begins to pass the weekly parade and review with the teeththoroughly; hygienically clean on all surfaces, every night before bedtime. Another problem which can develop during the transition years is the often heartbreaking,generally expensive proposition of crooked, mis-aligned teeth. This is such an important topicthat it will be treated separately in Chapter Ten, and it is mentioned here only because it is somuch a part of the age groups dental lifestyle. Periodic saliva testing is highly recommended during years 4 through 12, since this is themost dentally active time of life. If the childs grasp of hygienic maintenance is good, and theparents have reason to be confident, testing on an annual basis may be enough to reassure youthat all is well... or to catch any developing problems in plenty of time. If you have a "problem"child and want to make sure, it would be good to test on a more frequent schedule; semi-annuallyor perhaps every three months. Since the saliva tests are available at a cost essentially just enough to cover expenses, if usingthe test during the transition years helps avoid costly dental repair bills, it is certainlyeconomically feasible. In terms of what it can mean to parental peace of mind, and to the childsdental future, its easy to see why Oramedics recommends it so highly. In previous chapters youve been exposed to the concept of using a dental mirror at home, toenhance your capability to do a thorough cleaning job. During your childs transition years, this isa perfect time to "break him or her in" on this idea and we urge parents to obtain a lighted mirrorfor the familys use, preferably the "Floxite" mirror. The fact that these young minds are not totally able to process what they see in the mirror andturn it into useful information... not as well as adults, anyway... is more than offset by thepowerful motivation at work. Using a light and mirror "like a doctor" is fun, and it gives the childan opportunity to feel self-important. One of Americas more articulate proponents of self improvement is Dr. Maxwell Maltz. Inhis book, Psycho-Cybernetics, Dr. Maltz suggests that people of all ages can "act their way to anew feeling." In other words, we are generally capable of growing into attitudes and capabilitieswhich, at first, we perform only through role playing... yes, even through nearly wishful thinking. The more we can contribute to younger people during the transition years, allowing them to1
  • 59. act or role play under adult supervision, the more we firm up what they will become later on. Letthe kids "play dentist;" give them every opportunity to turn oral hygiene from a chore to animportant aspect of their daily life. If there is any one most important message for parents in these sections on protecting theprecious, the trying years and the transition years, it is the underlying element of parentalresponsibility; coupled with the fact that parents can help their children avoid all disease-relateddental problems. There are many young adults, folks in their late teens and early twenties, whogrew up in Oramedics guided families. All of them share two things in common: They have all oftheir permanent teeth --except in some cases where teeth were purposely removed to correctalignment problems... see next chapter... and none of them have ever had a cavity. Not one. Notever! Lets take a look at two advertisements. One of them you probably never saw, because itappeared in a trade magazine for the dental profession. The other is famous, and although it hasnothing to do with health, the message should come through loud and clear. Ready...? First Ad: "The average American child starts school with a new pair of shoes, a kiss from mother, and 3.7 decayed teeth," Second Ad: "Only you can prevent forest fires." Think about it, Mom and Dad. It is up to you. Your permanent teeth Why do we call the second and last set of teeth permanent, given the prevailing frame ofreference toward them? If, like most people, you still think of your permanent teeth as somethingyoull have from age 12 until about age 35, when its time to trade them in for dentures... thats notreally all that permanent, is it? The truth is that teeth are genuinely meant to last beyond a lifetime. In the absence ofdisease, these small marvels of natural health are virtually indestructible: They are, in every senseof the word, permanent. Oral health maintenance during the early adult years continues to be an extension of what waslearned during the formative years. At least once daily (bedtime) brushing, taping and rinsingeach and every tooth surface remains the primary element of hygiene maintenance. During these years the teeth will undergo a slow and very subtle change, as will theenvironment in the mouth itself. At the beginning, the principal symptom of disease will becavities. Toward the end of this period the emphasis will shift from cavity damage to gumdisorders. This will take place over such a span of time there will he nothing obvious to mark thechangeover. The progression into gum disorder does not have to happen... it shouldnt happen... and itwont happen if the health maintenance program continues properly through these years. There are a few "special problems" for this age group, and the two most universal are diet;and a more personal interpersonal involvement one toothpaste manufacturer emphasized byadvertising, "Hows your love life?" Dentists insist upon telling us, over and over again, to "avoid sweets." You know that whatwe really want to do is avoid disease --and if we do, sweets wont hurt our teeth. However, it isalso a plain fact that re-inoculation with the germs of odontosis will haunt us all our lives. Nomatter how you slice it, there will be strep and lacto present in the environment, ready to invadeat the slightest opportunity.1
  • 60. Sugar in any form will feed the free-floating, comparatively harmless germs, triggeringovertime production of dextrans --theyll generate excessive plaque. Theyll also reproduce fasterin a food-rich environment. Research has proven beyond question that it is not the kind of sugar we eat, or the amount,which is most critical: How frequently we eat... anything ... is the key factor. Teenagers and thosein their early twenties are notorious for their snacks and treats. Probably there is no way ever toavoid a lot of this, since it is part of their social structure. What we want parents and young adults to know is that frequent snacking and heavy sugarintake modifies the oral environment so that it favors rapid development of odontosis. The other social element of early adulthood is the boy-girl relationship. Not even the ADA isso obsessed with oral health theyd suggest doing without dates and foregoing necking. No way!Boys are going to find girls, and vice-versa; and they are going to kiss each other. More than that:They are going to kiss long and intensely... young love, itself, is pretty intense. If mama can inoculate a baby with germs simply by tasting a spoonful of food, what wouldyou think happens during a passionate kiss? Right on: me; love my germs...right? Kissing and eating... first you get the germs, special delivery --then you feed them, lavishlyand frequently. Is there any way to avoid this? ...Nope. Not for young people, anyway; not without seriously depriving them of many of thethings being young is all about. Instead, the solution is to constantly remain faithful and thorough in the minimum dailyrequirement of oral hygiene maintenance: Before bed, the teeth get cleaned...not just a lick and apromise, but super clean, squeaky clean. Even if its been a late date, and the young man or woman is really "dragging," the nightlyprogram has to take precedence. (Maybe especially if its been a late date, right?) Remember, itdoesnt take much more than five or six minutes to do an adequate job, once the person is adept. Ifthe child has been properly guided through the formative years, this will be no real trick at all.Mostly whats involved here is motivation and attitude: The young adult needs to know why itsdangerous to skip "just this once," especially if his or her hygiene has been so good for so longthat there just hasnt been any disease experience. The reason, and one which any young adult can cheerfully accept once its understood, is thathe or she probably "catches" odontosis... and "pours gasoline on the fire"... almost every day. Andso, every night, its once again necessary to "put out the fire." One final word of advice to people in this age group: If your family has a home prophylaxisdevice (an electric tooth polisher), you should read the information in the next chapter related totwice monthly use of this machine. Your benefits will be two-fold: The cosmetic (social) value ofyour teeth will be enhanced; and the medical (hygienic) contribution can be important in guardingagainst that subtle shifting from cavity-danger to gum disorder. For a Lifetime Now youve made it all the way to your early thirties. Obviously, most of those years werespent without any idea that you could prevent odontosis, so you have some problems with bothteeth and gums. Your situation is probably not critical, but there isnt much hope that you canavoid at least one more session with conventional dentistry. The damage done to your teeth is at1
  • 61. least partly irreversible; although natural healing processes will help, mechanical dentistryprobably lies ahead. For right now, the most important things you can do all revolve around stopping the disease.The damage, as you know, is symptoms. Your best response is to avoid any further developmentof symptom damage and as much as possible, to prevent existing problems from getting anyworse. You probably have cavities, some of which may be filled. Once there is a hole through theenamel of a tooth, the danger of decay and infection will always be there. Even when your oralhealth maintenance program has "done the number" on odontosis, you will always run the risk ofinfection or inflammation... because, as you now understand, there is a defective germ barrier inyour mouth. It will pay you to become very familiar with the chapters on first aid (12) and oral pain (13).There are two reasons for this: Its likely that you may need to know how to counter toothache,even though the disease which caused the original problem may be long gone. Also: You mayfind that your particular situation can be corrected, at least on a temporary basis, through the useof self-placed fillings . Another typical problem of people who came into the Oramedics concept later in life is thatthere are "gadgets" in the mouth...bridges, partials, etc. The special needs of such people areaddressed later in this chapter under the subtitle watch those appliances. Many older people suffer from some stage of gum disease. This is, in fact, the most prevalentdisease in the U.S. This subject is also important enough to rate its own subsection, perio-dont-itis, later in the chapter. Older people have an advantage over children in that they are capable of understandingconcepts the kids cant handle. Adults can be motivated through understanding; the promise ofheretofore un-experienced freedom from oral disease is enough to help most adults through thedifficult period of adjusting reference frames, changing attitudes and creating new habits. There is a disadvantage, however: The kids, if they are started properly in life, grow upbelieving in oral health care. The adults have to unlearn a lifetime of misinformation and learn a"whole new ballgame." So for those in this category, one of the most challenging things will be to overcome both theenemy "outside," being odontosis; and the enemy inside, meaning ourselves. Its true that peoplecan often be their own worst enemies. In becoming dentally self-sufficient, this is crucial. You have, in this book, the elements of an oral health maintenance program that can relieveyou of odontosis... but it isnt going to be easy for you. It could be; but, all things being equal, youwill probably suffer the relapses and the loss of either confidence or motivation that are a legacyfrom a lifetime of doing it wrong." Dont promise yourself too much, too soon: Please dont start out like a house a-fire, buyingup appliances and medicines and doing an entire therapeutic hygiene session four times a day.The outcome, for anyone but a fanatic, would be foregone: Youd soon lose the initial enthusiasmand after that, trying to continue your hyperactive program would become just too burdensome. You can begin an effective self-help program with a new tooth brush, some dental tape anddisclosing tablets... and the information contained in this book. The other things will help, andtheyll help make it easier; but keep in mind that you are dealing with an adult humanpsychological machine...the most complicated and contrary thing on the lace of the earth, yourmind and personality. One of the first things a young reporter learns after he or she goes to work is the KISS theory.Some gnarled old editor hands back a beautiful piece of prose the youngster wrote...a PulitzerPrize, for sure...and says, "Keep it simple, stupid!" Perhaps a modified KISS theory would be of some benefit for older people learning1
  • 62. Oramedics ideas for the first time: Keep em clean, kid! Just concentrate on this one element;keeping the teeth clean night after night after night, until it is second nature. All of therefinements, the add-ons in this book, can and will follow once you have mastered that onetechnique. Watch those appliances Many people of all ages are carrying around some combination of metal or plastic in theirmouths, in addition to natural teeth. These things may range from the picket-fence braces used byorthodontists to correct misalignment, through fixed bridges and splints to partials...whatever. All of these have one thing in common: At some point, touching living enamel, there is ametal or plastic anchor. The appliance is in tight contact with enamel or gum. In a mouthharboring odontosis germs, this is the setting for serious disorders to develop. If the appliance is removable... its designed so the user can readily remove it or replace it... itshould always be removed during the once-nightly hygiene performance. The appliance can andshould be thoroughly cleaned outside of the mouth, and the living surfaces that are contacted bythe appliance when in place can be thoroughly cleaned inside the mouth. This is very important, since when appliances are left in place during hygiene activities, oftenthe oral surfaces covered up by the wire, etc., do not get properly cleaned. These areas are ideal for the formation of plaque and, once the plaque sets in, active diseaseprocess can commence totally undisturbed by efforts to clean the mouth. In many cases, the appliances are not removable: Braces, fixed bridges, splints, etc. Whenthis is the case, the affected area of the tooth should receive scrupulous care. If there is any wayto get dental tape between the device and tooth enamel, do so. You may find the answer to beusing a threading device to help fed the tape over, under or around an appliance. Two such products, generally available, are J&J Companys "ZON Dental Bridge Cleaner"and Butler Companys "EEZ-Thru Floss Threader". Both of these companies offer brochuresdescribing use of these products and, if your drugstore doesnt have them on hand, you could getthe company address from the pharmacist and write for instructions. Especially for families with members wearing braces, the oral irrigator becomes more than aluxury; its a virtual necessity. Often orthodontic braces are so tightly fitted it is impossible to use floss, tape or brush toclean behind the metal. Time and again, braces have been removed after the alignment problemwas corrected only to uncover a horror story of rampant cavities and decay in the newly...andexpensively ...adjusted teeth. The oral irrigator, if one of quality, will force a stream of cleansing water pulses between theappliance and tooth enamel. For those with braces, nightly use of an oral irrigator --prolonged,thorough use --is almost a necessity if disease damage is to be avoided. Whatever kind of gadgetry is present in the oral environment, it will create hygiene problems.It is vital to the health of the whole mouth that these problems be solved, and the affected areaskept clean. Perio-dont-itis Gingivosis and its insidious traveling companion, periodontosis, can be overcome with1
  • 63. hygiene. Many people, facing multiple-thousand-dollar surgery as a corrective approach toperiodontosis, have discovered that proper hygienic approaches brought the disorder undercontrol and the operation wasnt needed. If youve forgotten the nature of advanced gum disease, it may help to review Chapter Five.The symptoms of this disease, if youll recall, are deep pockets between tooth and gum, often withinfection present. The gum is pulling away from the tooth and connective tissues are beingdestroyed. The typical conventional response to this is to operate, surgically removing the loosenedportion of the gum. The idea is to get rid of diseased tissue and open up the pockets to give theremaining healthy gum tissue a chance to throw off the infection. Oramedics Fellows have discovered that the use of an oral irrigator --in this case, specificallythe "Water Pik", with a specially-designed nozzle tip, will usually do at least as good a job as thesurgery ...and, in some cases, better. The special tip is more or less an extension of the standard "Water Pik" tip: The orifice of theconventional tip is replaced by a short length of surgical steel tubing... the same thing as thehollow needle of a hypodermic syringe. This tip will actually reach below the gum line and into periodontal pockets. It directs anextremely accurate pulsing flow of water, bathing the diseased areas that simply cannot bereached by any other hygienic method. Of course, it is beneficial if the infection can be countered with antibiotics; once again,prescription laws make cooperation of someone in the health care field mandatory. Even withoutantibiotics, however, response to irrigation treatment is often startling. The irrigation removespus, debris, germs and other irritants. At the same time, the pulsation massages remaining healthytissue to improve circulation. Time and again, the body proves that natural defenses can cope with infection... healing cantake place... if we will only keep the battlefield as clean as possible. Once disease gets the upperhand, the natural defenses are hard-pressed just to contain the disease, let alone to overcome it. If the damage and the continuing disease process are quite severe, often the victim will findthat he or she cannot use a toothbrush or even tape without further irritating the already-weakenedgum tissue. It then becomes a vicious cycle of disease-generating-disease, with the sufferer onlyable to fight a losing battle ultimately ending in the dentists chair for expensive surgery... orending with the loss of all the teeth. The oral irrigator has been a God-send to many in this situation; if you or someone in yourfamily is in this condition, it is something to consider carefully. People who are not yet this bad off have little room for relief: Early gum disorder,uncorrected, almost always becomes severe. The only response to this is hygiene. Pleaseremember that the major disease problem with adults is not cariosis... cavities... it is gumdisorder, gingivosis and periodontosis. Have you ever heard someone say, "I dont brush my teeth often because my gums bleed tooeasily"! The truth is there, its just in the wrong order. Lets fix it: "My gums bleed too easilybecause I dont brush my teeth often." If you presently have these disorders... sure!... your gums are going to bleed when you brushyour teeth, even if you are using, as instructed, the softest brush you can buy... and are taking itcarefully, easily. Dont give up! Short of truly severe disease, which would be evident by a lot ofbleeding, the minor bleeding of early gum disorder will go away fairly soon if you keep at yourdaily hygiene. On the other hand, it will probably never go away --just get worse --if you dont. Beespecially careful to keep your mouth clean during this period. Try to keep your hands away fromyour mouth; be on guard for anything and everything that could carry infection into the mouth.When your gums are bleeding, theres barrier tissue damaged, and so watchfulness and caution1
  • 64. are in order. Once again, however, natures way is to heal rapidly in a clean environment and, if youll doyour part, those gums will "toughen up" in a short while; a sure sign that youve begun to win thewar on odontosis.1
  • 65. Chapter Ten - Home Prophylaxis: an oral health "insurance" policy In earlier chapters weve mentioned the home prophylaxis machine, a battery-driven toothpolishing device. Perhaps the best known of these products is the "Tooth Pro". The companydescribes its product as "The new home dental care center." Anyone who has had a professional prophylaxis, which is nothing more or less than anextremely thorough cleaning of all tooth surfaces done by a dentist or a trained assistant, willknow what we are talking about. For the many who have never had this done by a dentist or a dental hygienist: A prophylaxisincludes (if needed) a scaling (scraping) of tooth surfaces to remove built-up deposits of calculus,and a polishing done with mechanical equipment. There is no better way to describe the latter partof this than to say the teeth are "polished." This can also be done manually, but its slower. Eitherway, the technician puts prophylaxis paste in a small rubber cup, about as big around as a pencileraser, and shines the teeth with it. If the technician uses a machine, the rubber cup whirls rapidly: It is a buffing machine. Theedges of the cup are very flexible and will conform to the various shapes encountered as the teethare cleaned totally free of stains, plaque, etc. With the advent of home prophylaxis devices, this can now be done by anyone with one ofthese machines. Manufacturers supply instructions with their product and this is all the averageperson needs to "have at it." What this can mean to oral health maintenance particular, for those in the years betweenfour and teenage... is like an oral health insurance policy. Oramedics has never seriously recommended semi annual prophylaxis at a dentists office.This twice-a-year trek to get em shined up is certainly not bad for oral health; it helps keep thecosmetics of the teeth in good shape, and the social contribution is perhaps worth the money for aprofessional job. However, research reported in the Journal of Preventive Dentistry effectively summed up theoral health value of this semiannual prophylaxis: Analysis of the data revealed that (six month) prophylaxis treatments did not alter the oralhygiene, gingival health, or caries activity of the participating children, nor did the childrensparticipation in the program motivate them to increase their frequency of tooth brushing. Thats not too hard to translate: It didnt do any good. However, research conducted withseveral hundred children in Sweden over about the same length of time turned up somethingremarkable: In that study, the children were given a prophylaxis every two weeks while no particularemphasis was placed on personal hygiene. The result was a genuine eye-opener: At theconclusion of the study, not one child shouted any evidence of active disease. A prophylaxis every six months seems to have little health value; a prophylaxis every twoweeks, regardless of personal hygiene approaches apparently stops the disease dead in its tracks. We turn now to an article which appeared in Good Housekeeping magazine in 1966: "NewMiracles to Fight Tooth Decay." The article discussed the work of Indiana Universitys Dr.Joseph C. Muhler, who was then developing new concepts in preventive dentistry for the armedforces. Its important enough to us that its worth direct quotation:1
  • 66. ...With the total conquest of tooth decay as his goal, the intense, dark-haired scientist hasbeen searching for a means to make obsolete his own achievements with stannous fluoride. Now he believes he has found the key --in a common mineral called zirconium ...dentalresearchers have always regarded as useless. But Dr, Muhler was intrigued by two seeminglyunrelated factors: The magnificent scratch-resistant glaze which zirconium imparts to fine china;and the disclosure that zirconium serves as the innermost coating of nuclear reactor chambers --a coating so powerful practically nothing can destroy it. Probing further, Dr. Muhler uncovered some more fascinating facts. Unlike most chemicals,zirconium has a special affinity for smooth surfaces. It clings to them tenaciously. Moreover, itspreads so easily that it gets into fine crevices. Finally, and most exciting of all, when it iscombined with other minerals --especially fluoride --zirconium makes them penetrate the toothssurface and become part of its structure. To Dr. Muhler the implications were obvious: Formulate a zirconium paste to clean andpolish teeth, and a zirconium fluoride solution to paint cavities --and he might have the mightiestweapons to fight tooth decay so far perfected. That article appeared more than ten years ago. It explained to the reader that, at that time, itwould be years before such materials became available --if ever. The Federal DrugAdministration would have had to be completely satisfied that such preparations had no harmfulside effects, for example. A dozen years ago, the zirconium/fluoride dream promised that, oneday, we might have "the mightiest weapons to fight tooth decay..." Today the dream is a reality. Zirconium polishing paste containing 1.23% fluoride is availableas Oramedics Tooth Polishing Paste. Because of the concentration of fluoride it is, obviously, aprescription item. It is available to anyone in the health care field able to issue prescriptions; it isalso available to individuals under Oramedics supervision. What does all this mean...? It means that with a home tooth polishing device, the average family can administer a verythorough prophylaxis every two weeks, to every member of the family. Obviously, this will not be 100% as "professional" as the treatment administered in a first-rate dental office, done by a truly competent hygienist. However, it will be extremely effective. Whether it would duplicate the effectiveness of the study which guaranteed freedom fromdisease through every-two-week prophylaxis would depend on how well it was done. One keypoint, however: In the study, no emphasis was placed on any hygienic activity other than theprophylaxis. In your home, a whole bunch of attention will be focused on the day-to-day oralhealth maintenance of your family, especially your youngsters. Youd give the kids a prophylaxis every two weeks (and yourself, too, we hope) --not as asubstitute for their own personal efforts, but to reinforce them. Thus, the prophylaxis wouldbecome "insurance" over and above the youngsters best efforts. Other benefits? --Sure: Youll recall that gum disorders generally begin when theres abuildup of calculus at the base of the teeth, near the gum line. Thorough hygiene maintenance,every evening, backed up with a thorough prophylaxis every two weeks, would all but guaranteethat no such buildup could take place. One thing the home prophylaxis machine cant do that the good hygienist will do is to cleanthe stains, accumulated plaque (if any...shame on you!) and other deposits from the inter-proximal tooth surfaces: Those hard-to-reach areas between closely-spaced teeth. The edge of therubber cup is too thick to fit in there, so how do we get that clean, too? We do that with dental tape. If youre able to use a prophylaxis paste, it will have a mildly-1
  • 67. abrasive content (zirconium, if you use Oramedics paste). This will remain in the mouth and onthe teeth immediately after youve finished with the tooth polisher. Simply use the dental tape andthe left-over polishing agent to "clean between." Even if youre not using a special cleaning paste, the theory still holds. In that case, the tapingwould be a very methodical, thorough cleaning of one space at a time, making sure every toothsurface was totally cleaned. It would mean, of course, that for your youngsters, you do it --eventhough the child is encouraged to do it for him or herself in the nightly program.1
  • 68. Chapter Eleven - Saving orthodontic dollars Given the choice between two tools, both equally suited to the job at hand, which would youchoose? Suppose one of these tools cost five dollars, the other a hundred. That simplifies it,doesnt it? You would naturally select the five-dollar tool. This is precisely the choice you should have available to you regarding orthodontic care.While this is a book aimed at helping people learn how to avoid unneeded trips to the dentist, inthis instance we are recommending that you make it a point to visit a dentist --for a very specialpurpose. Most of us know about the expensive braces, wires, etc., involved in typical orthodontic care.Some complicated cases can rip open your billfold for two thousand dollars or more. Manyparents have faced such staggering bills rather than permit a child to grow through thepsychologically tender years with teeth he or she is ashamed of. There is another approach, one that will cost perhaps five percent of the $2,000 "ouch" ofconventional orthodontic therapy. A simple test, utilized by only a small minority of American dentists, can effectively predictorthodontic problems before they occur. The test is called a Mixed Dentition Analysis (named for the fact that there are both babyteeth and permanent teeth --mixed dentition --in the mouth). By using this test when a child is sixto eight years old, the doctor can accurately predict many future problems and take steps toprevent most of them from happening. To perform the test, the dentist takes an impression of the tooth structure and then, from this,constructs a model that duplicates the "dentition" --the oral alignment and tooth size. He then studies the model, makes measurements and correlates these with what he saw in hisvisual examination of the mouth. With this data, he can accurately estimate the amount of spacethat is required for the remaining permanent teeth to come in correctly. The most common cause of misalignment is lack of ample space for natural development.Too many teeth, too large for the available space, will create problems. The pattern for thepersons dental progression begins forming many months before birth; numerous genetic andother complex factors all affect the childs future dental alignment. If the doctors assessment reveals a space shortage, he can take steps to prevent, or limit thescope of, orthodontic problems. By selective removal of baby teeth and, if necessary, permanentteeth, he can assure adequate space for other teeth to enter in proper alignment. If the situationhas progressed so that some problems have already developed, minor corrective measures, at anearly stage, are usually enough to take care of the trouble. Except in rare cases the use of complex, extensive (and expensive!) orthodontic appliances ispractically eliminated. In all cases, orthodontic care can be greatly simplified and of shorterduration...therefore saving time, money and the childs personal self image. Aside from the obvious financial advantage gained by using this method, there are other lessvisible advantages. For one: This method uses (works with, not against) the natural developmentof the teeth. This permits better anchoring of roots into bone support; any forced movement ofteeth can be injurious to the structure below the gum line. In extensive orthodontic cases, a problem called root resorption can take place; wearing downthe naturally sharp points of the roots. In such cases the teeth cannot possibly anchor themselvesas well as they would have if allowed to come in naturally --without forcing them to grow in anunnatural posture.1
  • 69. A second advantage is the freedom from hygienic problems invariably associated withorthodontic appliances. When braces and wires are present in the mouth adequate hygienicmaintenance is difficult, if not partially impossible. As a direct result, extensive decay is oftenfound beneath the braces when they are removed. In addition to pain to the child, here is yetanother expense. The teen years are a psychologically difficult time. Coming of age is a turning point for all ofus; often our personalities are shaped for life by emotional trauma during these years. Thepressures created by orthodontic devices, particularly the harassment by peers, is a tragic andoften preventable burden for any youngster. Most of these problems can be avoided, if early action is taken. The simple, painless MixedDentition Analysis can lead the way to preventing most of the orthodontic difficulties which candevelop if theyre ignored for too long. Talk to a dentist --to several, if necessary --about the Mixed Dentition Analysis for yourchildren. When you find a competent dentist, willing to do this and discuss the results with you,the small investment can lead to a lifetime free of orthodontic grief. If a dentist is interested but isunacquainted with the procedure... if hed like a refresher... he can obtain the Handbook ofOrthodontics by Dr. Robert E. Moyers, YearBook Publishers, Inc., 200 E. Illinois St., Chicago,Ill.1
  • 70. Chapter Twelve - Oral first aid measures Typically, we think of oral first aid as having only to do with toothache. Admittedly, thehighest incidence of semi-emergency oral problems will fall into that category, and so an entirechapter (following this one) has been devoted to this subject, "what you should know and doabout dental pain." What other situations call for some kind of first aid? Well, theres Bruxing: Grinding the teeth Many authorities believe published estimates on numbers of people who suffer bruxism --tooth grinding --to be too conservative. Even at that, one out of 20 adults and 3 out of 20 childrenare far too many when the solution can be so simple. Here again we find a common oral maladywhich both the profession and "public knowledge" have simply given up on... or address withexpensive remedial (surgical) procedures. Either "theres nothing you can do about it," or "Well have to re-shape four of the teeth, useorthodontic braces to relocate some of them more favorably, extract two that are in the way andinstall a bridge on one side, an inlay on the other. Would that correct the problem? --Who knows? In fact, authorities are not in harmony as to the underlying cause of bruxism. For years it wasassumed that stress and tension caused it: "Just nerves, emotional problems." Perhaps onecontributor to this theory was the knowledge that younger people suffer three-to-one incomparison with more mature adults; and everybody knows youngsters are undergoing moretransitional emotional stresses. Well, theyre undergoing more transitional dental stresses, too. More recent professionalagreement holds that the cause of bruxism is probably a combination of factors: mis-alignedteeth, something dentists know as malocclusion; and probably some nervous tension. Of thiscombination of contributing factors, the physical relationship of the teeth is probably the majorcause. Studies have not turned up any significant long term psychiatric or psychologicaldifferences between those who grind their teeth and those who dont. Whatever the cause, tooth grinding can drive others in the family "right up the wall." In thestill of the night, this noise can become so loud it seems to fill the house; waking parents orspouse, brothers or sisters from a sound sleep. It is pointless to wake the grinder up and complain: The grinding stops when he wakes, sure --but it starts again when sleep returns. Nor is this something which others in the family should try to ignore out of tolerance for themember who suffers from the problem. The individual may not even know he does this, even if ithas become a pattern over many, many years. It can cause some pretty serious problems; soignoring it, tolerating it, is not doing that individual a favor. Normal teeth can exert excesses of 30,000 pounds per square inch in chewing: Think whatthis means when a person is grinding the teeth, which selectively puts the full pressure-loading onone or a few of the teeth rather than the full display. It can chip teeth, or crack them. It can actually loosen them in their sockets: Rocking thetooth back and forth, repeatedly, can cause the jawbone to recede from the root. Any minorinfection or irritation related to gum disorders can be aggravated by the constant tooth motion.Periodontal pockets are formed more easily under these conditions.1
  • 71. Theres more: The muscular stresses involved cause movement of the muscles controlling thebite, seeking to accommodate a more comfortable jaw position. This, in turn, mis-alignssomething else --more bruxing. The muscles and nerves of the oral environment have to live inharmony and concord with those in the face, neck, and head. When there is discord, thesymptoms can spread elsewhere and show up as earache, headache, stiff and sore neck, shoulderand back muscles...and more. The stresses and strains in the inter-related whole-body system will trigger reflexes seekingcorrection. The most likely neuromuscular reflex to stresses caused by bruxism is...right on: Moreof the same...grinding the teeth. What should you do about it? Lets ask the American Medical Association. As it appeared inthe A.M.A publication Today s Health: Tooth grinding (bruxism) is largely an unconscious habit that can damage teeth, andbreaking the habit has often been a frustrating problem for both patient and dentist. Recently asimple, new method has been suggested by Marvin P. Levin, D.D.S., and William Ayer, D.D.S., atthe U.S. Army Institute of Dental Research, Waiter Reed Army Medical Center, Washington, D.C. Fourteen bruxism patients were instructed simply to clench their teeth together as hard aspossible for five seconds and then relax the jaw for five seconds, to repeat the procedure fivetimes, and to continue the exercise six times daily for two weeks. Within 10 days, 11 of the 14 had successfully eliminated the grinding, and thus far, for sixmonths, have not resumed the habit. (53/1/:12,1975) Does it work for everybody? Maybe not; there is not enough data available. It works for anumber of people who first heard of it through association with Oramedics; there arescientifically-sound reasons why it should work for most people. If there are family members with bruxism problems in your household, it is easy to institutethis simple (and absolutely free) therapy. It will require follow-through: Theres a fairly conscientious effort involved in doing anythingsix times a day for fourteen consecutive days. Adults will have to make a determined effort (yougotta wanna!) --and parents will have to do a heads-up job of supervising youngsters. Make an effort...a genuine effort... if this problem affects you or a household member. Itsimportant to oral health and peace of mind, both, to find a solution. Canker sores If there is anyone in the country who hasnt suffered from one of these painful little lesions,he or she is most unusual. Sooner or later almost everyone "gets a canker" in the mouth. Somepeople seem plagued with these little devils; there are some periods during development fromyoungster to adult when activity seems heightened. The canker sore itself is bad enough, but it frequently has complications... secondaryinfections... which make it even more painful and dangerous, and further retard the naturalhealing process. Remember: The "skin" inside the mouth is a barrier tissue and any breach in thisbarrier is an open sesame to infectious microorganisms. A canker lesion is most definitely abarrier-tissue breach. Cankers are caused by a virus; the Herpes Simplex. This virus seems to be present in nearlyeveryones system and becomes active and evident when something triggers it. Herpes lesions arenot limited to the mouth. One type of venereal disease, with increasing incidence in this country,can be traced to the herpes simplex virus. We dont have any medication in the present arsenal to counteract herpes lesions. Once theyappear theres nothing to be done except guard against secondary infection and decrease the1
  • 72. discomfort. And, while there is no specific medication to attack the virus itself, there arepreparations that can speed the healing of the lesion. If left alone and not subjected to secondaryinfection or constant irritation, the lesion will go away naturally; one medication seems to helpthe natural processes and make it go away sooner. The medication used against the canker sore is a protective paste that is probably nearlyimpossible to obtain as a generic item. It is readily available in most drugstores as trademarkedproducts, however. There are two general variations on the basic formulation. These are: 1. "Orabase" (Hoyt Laboratories): This preparation is available without a prescription. It maycontain Benzocaine, a topical analgesic that will relieve much of the discomfort of a canker sore. 2. "Kenalog" in "Orabase" (Squibb Co.): This preparation requires a prescription because inaddition to the basic protective paste, it contains triamcinolone acetonide, a corticosteroid. The base, or paste, is compounded of materials that form a protective film over the canker;even on wet tissue, even bathed in saliva. The film helps keep debris and infectious organisms outof the sore and reduces the constant irritation. In itself, that begins aiding the natural healingprocess. The discomfort is greatly relieved by this protection, even if it werent for the analgesicingredients of the preparation. However, the ingredients of either preparation will help reducepain and irritation even further. If you can obtain Kenalog in Orabase it is capable of relieving canker sores very rapidly.Since it is a prescription item, you may want to use it under the supervision of someone in thehealth care field. Orabase with Benzocaine is the non-prescription preparation and it, too, is very effective inreducing discomfort and promoting natural healing. The results will not be as rapid, perhaps, aswith the Kenalog preparation, but it will be vastly superior to simply doing nothing; suffering thepain for the full term of the herpes ulcer to run its course, and running the constant risk ofsecondary infection. Trauma and Inflammation Trauma is something which "happens" to the mouth: It gets hit, or burned, or cut for example;inflammation can be a result of trauma or it can result from irritation. For minor trauma, you may want to consider Orabase with Benzocaine (see precedingsubsection) as a temporary shield to prevent further irritation and relieve discomfort. Often, relatively minor trauma in the mouth will "take care of itself" in time. Burns from hotbeverages, for example, unless unusually severe, more often than not will cease hurting within afew hours and be completely recovered the next day. Frequent rinsing with saltwater solutions is an excellent response to minor trauma, also. Ifswelling and inflammation are present, the salt solution will help reduce these symptoms andbring earlier healing and relief. More serious trauma will be accompanied, usually, with dental pain. The next chapterdiscusses this fully. Sometimes we dont know the source of the trauma; this is particularly true with "mysterious"inflammation that we cannot associate with any blow or burn in the mouth. The response is thesame, anyway: With commonsense, determine whether to respond with salt solution baths or bycovering the traumatized region with Orabase or to do nothing, just keep the situation under closeobservation until it begins to improve. Obviously, if severe trauma occurs or if relatively minor inflammation begins to turn ugly,perhaps showing signs of infection, the decision to seek more capable advice is always somethingworth considering.1
  • 73. Broken teeth -- Empty cavities These two situations are fairly comparable, in the sense that the enamel barrier surface isobviously defeated. Moreover, particularly in the case of a freshly broken tooth, the nerve(s) willbe signaling "bloody murder" to the brain: Translated as pain. Immediate first aid (for either abroken tooth or a lost filling) is to cover the entire affected area with a temporary seal. If there isnothing more sophisticated at hand, use sugarless chewing gum. As soon as possible, the patch job will have to be replaced with something more permanent.In the case of a broken, cracked or chipped tooth it will probably require the assistance of adentist. Just as you would turn to the medical profession for help in the case of a compoundfracture; so it is with dangerously severe trauma to the teeth or gums. In the event medical or dental assistance is not available, a more permanent repair for abroken or chipped tooth would be to use the same material as a temporary filling, shaping it withthe fingers around the entire affected area of the tooth. Use of a preparation containing Benzocaine will help reduce the pain; as will aspirin takeninternally. The main objective is to cover the area with an airtight seal. This serves two purposes:We want to get the nerve-sensing apparatus away from air and, if possible, shield it fromtemperature extremes; and we want to replace the barrier surface with some thing to help guardagainst infection. Tooth completely knocked out When teeth are knocked completely out of their sockets through some accident a competentdentist can re-insert them with successful re-implantation virtually assured under the rightcircumstances. The two most important conditions are outside of the dentists control, and thatswhere a well-informed lay person can make all the difference. Those conditions are the time lapse between the tooth loss and attempted re-insertion; and theextent to which the tooth or teeth have dried out. Of these, the second is the most important. If it is a fact (and it is) that teeth can be re-implanted --often, if not usually, returning to theirformer condition; then why is a dentist necessary? There are a number of reasons, but letsconsider three: 1. If any infection sets in, the chances of successful healing are practically nullified. 2. The tooth, or teeth have to be fastened, somehow, to give tissues time to knit. Think of thisas a cast on a broken bone...but how do you put a cast on a tooth? A dentist should be able to usewire or perhaps moldable materials to firmly brace the teeth in proper alignment. 3. Proper alignment is the name of the game, with teeth; lay persons would find it verydifficult to ensure proper "fit" into the alveoli (bone sockets) and proper occlusion (bite fit) whenre-implanting teeth. The meter starts running, so to speak, the moment teeth are knocked out or pulled out of theirsockets. Two things begin happening: --The gum and jawbone begin the natural healing process, and --The tooth (teeth) begin drying. Youll recall from the section on anatomy that teeth are anchored in place by connectivetissues. It is these, more than anything else, which will "make or break" chances of replacing thetooth. Once the connective tissues have dried out completely while the tooth is out of its place theprobability of rejection is greatly increased.1
  • 74. The healing process inside the mouth is somewhat slower, but after too much elapsed timetissues will have scarred, blood vessels will have closed off and the socket will have begun toheal shut. The most important first-aid measure is to find the teeth which have come out, and keep themmoist. Ideally, put the teeth in a cup and cover them with water and a slight amount of salt. If youcant do this, use ingenuity: Come as close as you can to the tooths natural environment. Youcould spit into a handkerchief or napkin and wrap the teeth in it; you might even want to put theteeth in your mouth as an emergency measure until you could protect them otherwise. Obviously,the latter measure assumes you... or whomever does this... will remain conscious and calmenough not to accidentally swallow. Even if all you can do is carry the teeth in your hand, keep them moist... any way you can.Spit on them if theres no other means. Then, of course, get to a dentist as quickly as possible. The time element is on your side if theteeth are properly cared for. There is one case on record at Oramedics headquarters in which anauto accident victim had teeth replaced several days later. In that case, police officers were sent tothe wrecking yard to sift the automobile for teeth and even though drying had become serious, there-implantation "took." This information should be shared with everyone in your family and with friends and co-workers. Nobody likes to think about accidents, especially those severe enough to result in toothloss, but knowing what to do is important. Anyone at the scene of such an accident can do thevictim a real service by having the presence of mind to find and preserve any teeth lost in theepisode. Temporary fillings Weve described two kinds of temporary filling material: The kind you mix yourself out ofzinc oxide and eugenol, and the kind you buy ready-mixed, such as "Cavit" There are otherpreparations on the market which are more easily found in drugstores. These are the verytemporary fillings called "toothache remedies." Two such preparations are "Red Cross" toothache remedy and "Dents" toothache gum. Bothof these contain eugenol and/or Benzocaine and will, therefore, bring relief from toothachecaused by an empty cavity. The Red Cross type of preparations are a liquid and small sterile cotton pellets. The pelletsare soaked in the liquid and then inserted and tamped into place in the cavity. The Dents gum isnot a chewing gum preparation. Instead, it is eugenol and Benzocaine in a base of cotton and wax.A piece large enough to fill the cavity is trimmed off the supplied brick of wax, shaped to fit thecavity, and inserted and tamped into place. In the event you have some zinc oxide-eugenol or Cavit on hand either of which will make abetter seal and will allow the user to chew or drink normally --it might still be a good idea to firstuse one of the less permanent "temporary" fillings. The reason for this is to make sure there isntactive infection in the underlying nerve chamber itself before installing a semi-permanent filling. If you were to seal off a cavity with nerve chamber infection present, the odds are that youdbegin to build pressure in that tooth. The result would be the opposite of what we are trying for:youd find the pain and danger increasing instead of diminishing. By making the filling easily removable, you could "try it" for several hours to see if there wasan adverse reaction. If youre using a cotton pellet preparation, you might want to "plug the hole"with sugarless chewing gum after inserting the pellet. This would give you the airtight seal youwould need to ascertain whether or not the cavity will accept a filling without flaring up.1
  • 75. To prepare the cavity you must first be absolutely certain it is clean. This means using brush,Water Pik if at hand, toothpicks, dental tape... anything ingenuity tells you to employ... to ensurea clean cavity. Then try to make it as dry as possible. An enema syringe or empty atomizer willgive you an air-blast that will help with this. Using the materials provided with the Red Cross style or Dents style toothache remedy, packthe cavity according to the manufacturers instructions. Do it as tightly as you can. Remember:We are trying to seal the cavity. If, after several hours, the tooth shows no signs of increased discomfort, you may wish toremove the initial filling material and immediately replace it with the zinc oxide-eugenol or Cavit-style filling. When the ZOE or Cavit is placed be sure all excess material is trimmed before it sets up hard.One common mistake is to leave too much material on the biting surface of the tooth, particularlyif the cavity being filled is not at the side of the tooth but is more or less "top-downward." In such cases, remember that the chewing surface of the larger teeth is generally concave orhollowed out. Dont make a little mound of filling material or youll find that the opposing toothwill impact on the filling before the jaw is fully closed. Now youll have another problem: Youveupset the occlusion; youve created an artificial "bad bite. This will of course interfere with eating and chewing habits. It will also probably "insult" thecavity youve just filled after a while. Any constant irritation anywhere in the body usuallyproduces a defensive reaction. The result would very likely be inflammation and perhapshyperemia and yet another kind of toothache problem. (See next chapter for a discussion ofhyperemia.) Such a condition might very well also introduce bruxism --tooth grinding --in an effort tocorrect the misalignment.1
  • 76. Chapter Thirteen - What you should know and do about dental pain Dental pain will almost certainly affect everyone sooner or later. Even those who are immuneto dental disease, or have long ago achieved zero disease levels in the mouth, can experience theexcruciating pain of a toothache. Dental pain is most frequently associated with the process of disease...odontosis...and isnormally considered to be the expected result of tooth cavity. While this is not necessarily theonly cause of toothache, it is by and large the most usual source of the problem. Even those who have defeated odontosis through a personal program (Oramedics or other) ofhygiene and oral self-help care may suffer from this symptom. Remember: The disease may verylikely have produced cavities before it came under control. As long as those cavities remain in theteeth, they may he the potential site of a toothache. Other sources of toothache can be trauma, the medical term for damage such as caused by anaccident, a blow, a fall in which the mouth strikes a hard object or surface. Severe bruxing (toothgrinding) can cause trauma leading to toothache. Refer to Chapter Twelve for more informationabout bruxing. We can also implicate the nerves, themselves, as the source of pain. While lessfrequent than pain caused by pressure, infection, inflammation, trauma or other insult to thenerve, this very "real" pain will have the same end result: It hurts. Dentists are familiar with thistype of "ghost" toothache, in which the patient insists a particular tooth is hurting --and there is noreason for that tooth to be acting up at all. Nerve tissue ordinarily cannot regenerate and completely dead nerves do not transmit pain. Adamaged nerve can telegraph a variety of false impressions to the brain; insisting it is cold, or hot,or numb, or in pain --when there is no actual stimulus, no reason fur that nerve to be sending anymessage at all. Illustration 3 shows the network of nerves which are related to the teeth. In passing, noticethat the upper trunk-line from the brain has branches serving the cheek and other facial areas.This is the network that is involved in the rare, extremely painful disorder known as trigeminalneuralgia, often called "tic douloureaux." In that particular malady the nerve system itself signals intense pain without any apparentreason. The intensity of pain has been so great in some cases as to cause sufferers to suiciderather than endure it. Notice also that each tooth is served by a "private line" from the tip of the root(s), which tiesinto the main trunk-line leading to the brain. Almost everyone, using the telephone for longdistance calling, has experienced the phenomena of "cross-talk." In this situation you suddenlyhear another conversation, separate from your own; sometimes quite clearly. This cross-talkoccurs sometimes with the nerve system serving the teeth, also. Since the nerve systems areidentical, but mirror images, on each side of the head, cross-talk can take place between teetheither on the same side of the mouth or across from each other. This means that sometimes there will be tooth pain which the victim will feel veryspecifically in one tooth... when there is nothing evidently wrong with that tooth. In these cases,the offending tooth can often be found by careful examination. There can be no pain without involving nerves in one way or another; so take time to becomefamiliar with the illustration of the nerve system and remember that in some exceptional cases,toothache is neuralgia --nerve disorder --without some physical tooth involvement. If you are ledto strongly suspect this, after careful elimination of the more ordinary sources of toothache, it1
  • 77. would be appropriate to bring it to the attention of someone in the health care profession.Obviously, if there is nothing you can implicate, yourself, as the source of pain, there is going tobe nothing you can do for it other than take aspirin and wait. If the situation gets worse, or showsno improvement, it is beyond the scope of lay diagnosis or treatment. Generally, toothache is caused by invasion of disease; it is a symptom. The principalproximate causes of pain are infection or inflammation. These are not the same. Inflammation isoften seen when infection is present; but inflammation can also be present without infection. Inflammation will not respond to antibiotic treatment; infection usually will. If theinflammation is the result of infection, antibiotics are indicated. When infection is present it is caused by invasion of micro organisms (germs). It is thereforea disease process, a disorder; usually best treated by use of antibiotics when available. check symptoms examine ask questions The first thing to look for is swelling and redness. Start with the suspected tooth and adjacenttissues. Since infection is the more frequent cause of pain, this will be the first thing to look for; itwill show up as inflammation (swelling with or without redness). The evident swelling may be inthe gum tissue, the cheek or tissue adjacent (proximate) to the tooth. If the infection is in the boneor is inside the tooth, it may manifest itself by pushing the tooth slightly out of its socket. While not visible, this second kind of swelling is often the easiest to spot because the toothwill feel "high" when biting; it hits the opposing tooth prematurely. While we are talking onlyabout tiny fractions of an inch, the difference is magnified in the sensation of biting and willusually be easily detected. (if you want to test this, bite slightly on the corner of a page of thisbook...youll "feel" that contact through your teeth without any mistake.) With a "high" tooth, when pain is present, this tiny increase in pressure is immediatelytranslated, by the insulted nerve, as magnified pain. When dealing with someone too young to accurately describe symptoms (or if there is alanguage barrier, etc.), try pushing down on the suspected tooth with a fingertip and watch for areflex action indicating increased discomfort. Since antibiotics are the best treatment for infection, this will almost always involve theimmediate supervision of a physician or dentist; or at the very least, a prescription. OramedicsFellows have learned through experience that the most effective use of antibiotic for oralinfection is "Lincocin", I.M. (I.M. means intra-muscular: a "shot" in the muscle tissue; aninjection.) The normal adult dose is 2c.c. and may be repeated in two or three days with severe cases...usually not necessary. The reason the antibiotic is not given orally (pills) is that an injection gets the medicine intothe bloodstream... and on the job... much, much faster than pills. Because infection in a tooth isthe cause of extreme pain, we want the antibiotic to go to work quickly rather than prolong thediscomfort unnecessarily. In the event medical assistance cannot be obtained to prescribe or administer antibiotics,treatment will involve use of pain reliever and mouth rinsing. There is no better analgesic --painkiller --available without prescription or potential side effects than plain aspirin, U.S.P. This isavailable under a multitude of trade names and brands, but is always identified somewhere on thecontainer as aspirin. Aspirin is always taken internally, following dosage instructions given by the manufacturer.Do not attempt to apply aspirin topically... directly to the tooth, cavity or inflamed area. This1
  • 78. common "home remedy" should never be attempted. There is fairly common knowledge that crushing aspirin and putting it into a cavity cansometimes bring relief from pain (as with most folk remedies, there is an element of truth to it).However Aspirin is an analgesic only when it enters the bloodstream. There is nothing in itschemical composition which would work as a pain reliever when applied topically. The reason it may sometimes appear to bring relief when used in a cavity is because it is acid.Aspirin, U.S.P., is acetylsalicylic acid --and the reason your Aunt Maude or Uncle Charlie mayhave gotten relief from pain by sticking acid into a cavity is because it fried the nerve ends. Asmuch as we wish for you to find relief from pain, it should never be through destruction ofhealthy tissue. Lets quote from Dr. Peter Wingates Medical Encyclopedia: ...but aspirin is not harmless. Very large doses cause a severe and sometimes lethal acidosis.The usual symptoms of mild poisoning are giddiness and buzzing in the ears. Regular doses as small as two or three aspirin tablets a day can cause bleeding in thestomach... The risk may be less with soluble compounds of aspirin, but it is not overcome... Before we leave this subject, please remember that there is more about aspirin, and somemethods of using it, to be found in Chapter Seven; the section dealing with your own home"medicine chest" for dental self sufficiency. After administering the proper dose of aspirin to compensate for toothache pain, the sufferershould remain as physically quiet as possible. Since the pain is caused by pressure, any exertioncausing the heart to pump more heavily can produce small but noticeable additional pressure --asanyone who has experienced a "throbbing" headache or toothache can verify. Begin rinsing the mouth frequently with a solution of salt and water, adjusting thetemperature for maximum comfort. Note: If the tooth is quite sensitive to extremes of heat orcold; particularly if the pain increases substantially when heat is applied and "feels better" whenvery cold, it may be symptomatic of nerve degeneration. If this reaction occurs, be sure to readcarefully about this condition later in this chapter. Whether the immediate symptom (infection) is brought under control through antibiotics, orgoes into remission by natural physical defenses after bathing in salt solution, the cause of theinfection should be determined and steps taken to prevent recurrence. The most usual cause is a breach in the enamel barrier defense of the tooth; and ordinarilythis breach (hole) is produced by a carious lesion --a cavity. This can be a heretofore unsuspectedcavity, or one which has been known for some time but which has been dormant. It might be froma filling which has become loose, or is lost altogether. In numerous cases, the area of a "filling"creates a zone in which germs can easily colonize: Often a second cavity will form adjacent to anotherwise efficient filling. Until more permanent repairs can be made, there are two ways to guard against a recurrenceof infection. The first, of course, is hygiene: Being extra careful to keep the problem tooth, andcavity, as clean as possible. The other approach, which is particularly useful in the case of larger cavities or missingfillings, is to use a temporary filling to seal the area. The method of placing a temporary filling isdescribed in the chapter on Dental-oral first aid, Chapter 12. Localized infection is usually associated with some breach, as we mentioned, in a barriersurface of tooth or gum. For a thorough discussion of this barrier surface, please see Chapter 4,The anatomy of the mouth. For now: The enamel of the tooth and the outer layer of tissue of lips and gums is a defenseagainst germs. When this surface is properly functioning, there is no way for infection-causingmicroorganisms to get into the tooth or tissues from outside. Any infection that occurs without any fault in this barrier system must be introduced through1
  • 79. the circulatory system... the blood stream. This occurs elsewhere in the body, and people are moreor less familiar with such things as skin boils, pimples, etc. --Familiar in the sense that suchthings dont seem to cause the same level of fear or dread as they do when it happens "in themouth." When infection is introduced to tooth or gum from the blood, there is ordinarily apathological reason for the germs to invade at that one point. What does that mean? Pathogenesisis, simply, "the process by which a disease develops." In this case something provided an affinityfor the invading microbes: A deep periodontal pocket... a degenerating nerve... some disorderwhich provided a focal point for microbial invasion. You wont always be able to discover the reason for the localized infection. Look for a logicalcause, of course, and suspect such things as a cut in the gum tissue, a lesion of some type, such asa canker sore, a hole in the tooth, some disorder of adjacent gum tissue, a periodontal pocket orother visible problem; Incidentally, there are problems with the health of gum tissues that are not odontosis. As anexample of such disorders, scurvy is a "defect of the substance that binds cells together,especially in connective tissue and capillary blood vessels, due to lack of vitamin C." --WingatesEncyclopedia Any such disorder not attributable to odontosis and which does not respond to hygienic andnatural systemic defenses should obviously be brought to the attention of someone in the healthcare field. If, as is often the case, the cause of the problem is a cavity, a decision will have to be made asto what to do about it, and when. While its true that in an oral environment without activeodontosis, the cavity wont get any worse... its equally true that once it has advanced beyond thestage where it could be naturally healed, it will never get completely "better" without help. Sooner or later, when cavities have broken through the outer enamel into the interior of thetooth, the situation will have to be taken care of. The temporary filling described in Chapter 12 isnot meant to be a lifetime solution to the problem. In the event of significant cavities, after the immediate infection has been countered and thepain relieved; after the temporary filling is installed to guard against recurrence of infection, youmay want to consider plans to seek dental repairs when convenient in terms of time and money. When there is no infection Inflammation can occur without infection. It is the evidence of the natural defensive reactionto injury or irritation in any part of the body and while it is most obvious as a response tobacterial infection, it may be evoked by anything that damages living tissue. Think of irritated, inflamed eyelids as an example; or of the swelling and redness of nostrilswhen you have a "runny nose" and resort to frequent "blowing." The redness and often swellingaccompanying inflammation is a sure sign that the bodys natural defenses have been called intoaction by something which has insulted its tissues. When you see inflammation and cant find any reason to suspect infection, ask questions."When was the last time I got hit in the mouth...? --Burned my mouth with hot liquid...? --Bit intoa pitted prune and found out (ouch!) they left the pit in that one...? Inflammation is often the result of insult or trauma: In some way, the teeth or tissues havebeen abused. If the abuse can be determined, usually there will be no problem in decidingwhether the damage will "go away" if the mouth is pampered for a while, allowing naturesdefenses time to do their work. Remember, however: Inflammation is a warning signal, and it may be a warning that a barriertissue is damaged --cut or broken --or that the nerve or bone has been traumatized. Wheninflammation is present, exercise caution and watch for signs that infection may be setting in.1
  • 80. When there is no inflammation When pain is present and there is no evidence of infection, no swelling and no "high" positionof the tooth, it is likely that the tooth is experiencing hyperemia, or congestion, within the nervechamber itself. In this condition the problem is contained wholly within the tooth and is notpressure exerted at the jawbone and/or gum line. See illustration 2, a cross-section of a tooth, for a more complete understanding of what ishappening. When the nerve chamber has been insulted it can undergo internal inflammation. Thiscan cause a slight swelling; an edema: Excessive fluid trapped in a body cavity or tissue. Since the nerve and circulatory tissues completely fill the confined nerve chamber area, eventhe slightest edema or swelling can cause excruciating pain. The quickest test for hyperemia is to check the effect of temperature extremes. If hot coffeeor food increases the discomfort; and if cold water, ice cream or even cold winter air also bringsmore pain, hyperemia of the nerve is quite likely the problem. When hyperemia is the suspected source of pain, aspirin (internally) may be used to alleviateit. In the absence of visible disorder --trauma, cavity, etc. -try to establish whether that tooth hasbeen insulted by a shock in recent past, or otherwise establish if you can a logical cause for thecondition . When there is no evident cause of hyperemia, very little can be done other than to restquietly, take aspirin and use salt-solution rinses (being careful to adjust the rinse temperature soas not to create additional pain). If the probable cause of hyperemia is a visible cavity, or a break caused by injury, refer to thechapter on first aid and attempt to bring the situation under control with a temporary filling. In the case of hyperemia, one of the components of the temporary filling process, eugenol,helps to quiet the nerve and reduce the inflammation, thereby alleviating the pressure. Often relieffrom pain will be evident within minutes. If pain strikes while at work or otherwise away from your medicine cabinet, the test forhyperemia can be made with any convenient hot and cold food or liquid. If the hyperemia isbrought on by injury, the test isnt necessary: The victim will know what caused the problem. As a source of immediate first aid, in order to protect the tooth and bring some relief, thevictim should chew a stick of sugarless gum and place it into the cavity or like a "bandage overthe broken tooth. This is, at best, a very temporary repair, but it can often bring enough relief tofinish a shift at work, or "buy time" for the victim to return home to effect more lasting first aidmeasures. The same "chewing gum trick" can be used if a person suddenly loses a filling or accidentallychips or cracks a tooth, even though there is no immediate pain involved. The "patch" ofsugarless chewing gum will help reduce exposure to possible infection; it should help keep germsand debris out of the area, and it will help reduce the tooths sensitivity to temperature extremes.1
  • 81. If heat hurts but cold comforts In testing for hyperemia another situation may turn up; if it does, it is more serious andrequires special attention. In this condition, the victim will discover that application of any heatcauses immediate, pronounced pain increase while application of cold brings relief. This isevidence of nerve degeneration; the nerve is dying. Infection may not yet be present but almost always will follow. What is happening is that thenerve is mortifying and if it is decaying as it dies, it is gangrenous. The protein breakdownassociated with decay (gangrene) creates gas. This gas fills the nerve chamber and may spill outinto the bone at the root tip. The gas, of course, pressurizes the nerve chamber and while the nerve remains able torespond to stimulus, this will register as intense pain. Since the pressure is caused by gas,application of heat causes further gaseous expansion and increased pain. Conversely, applicationof cold will cause the gas to contract, reducing pressure and relieving pain. Sometimes thedecrease in pressure is enough to be dramatic: The pain goes away completely. This of coursedoes not mean the nerve degeneration has ceased. Immediate treatment for this condition is aspirin and saltwater mouth rinses, adjusting thetemperature of the rinse as cold as possible to help reduce pain. Nerve chamber degeneration usually becomes involved with infection in some way. Ifunchecked, such infection will probably fistulate (erupt) through the bone and/or gums and beginto drain into the mouth. Such draining is normally preceded by a gum boil. At first the generalarea of the affected tooth will be inflamed and swollen; it will be puffy and very tender. As the combat between natural defenses and invading infection continues, the generalizedinflammation will begin to localize into a boil. This usually means a stand-off: The body hasmanaged to contain the invasion to a defined area; the infection has managed to establish a"beach-head" and is not likely to "just go away." Of course, the pressure from inside the tooth is not helped by this pressure at the root tip or inthe gum where the boil is forming. While the application of cold liquid reduces pain from thegaseous expansion, it does very little for the pain associated with the gum boil... or, as it is morecommonly identified, the abscess. In order to relieve this pain, and to help nature in its battle with the infection, the abscessshould be opened and drained. (If it isnt, it will very likely burst spontaneously when the buildupof pus and other infection by-products erupts through the gum tissue). Care should be taken to rinse the mouth thoroughly and often with salt solution, spitting thefluids out: The by-products of this infection can be poisonous, or at least quite capable ofinducing nausea. Anesthesia is usually unnecessary when opening a gum boil, since the outer layer of skin isvery thin. Also, the application of cold liquid further desensitizes the area. A swift, small incisionin the center of the localized infection will release the trapped fluids and usually bring almostinstant relief from pain. If medical assistance is not available, the same effect can probably be obtained by sterilizinga needle (heat it) and puncturing the gum boil with it. Again, there would be very little paininvolved, and relief would be almost instant. Obviously when there is infection as rampant as is the case of an abscess, antibiotics shouldbe considered the first line of defense. The capacity for natural healing is jeopardized: Therewouldnt be a boil if the body was able to overcome the infection by itself. When available,antibiotics should be used. In any case, the existence of an abscess anywhere in or on the body indicates that physicaldefenses have localized and contained an area of infection. The best help for Mother Nature,1
  • 82. without or without antibiotics, is to open the boil and drain the pus. The area involved in a boilcannot heal until the "mess" is gone. Natural defenses can sometimes slowly overcome theinfection and more slowly do away with the residue of pus and fluids...but it is almost alwaysbetter to "help nature" by opening and draining the abscess. Summing up Generally: Toothache is caused by infection, or by hyperemia, or by nerve chamberdegeneration, or by abscess; sometimes with combinations of these present. Swelling and redness mean inflammation: Determine whether caused by trauma or insult; orby infection. In many cases of inflammation of obvious external cause, the problem will go awaywhen the tissues recover from whatever irritated them to begin with. Use aspirin (internally) forpain; use frequent salt solution rinses to keep the area clean. Pamper inflammation, and keep aneye on it. Watch for infection to follow if the cause of inflammation was such that barrier tissuesare broken, or if the nerve chamber was insulted to the extent that it begins degenerating. Sensitivity to heat, relieved by cold means degeneration of the nerve or nerve chamber; it isdying and may be decaying. Gangrenous activity is present, creating gas and causing internalpressure. Look for infection to localize itself as a: Gum boil (abscess): Drain the area by incision or puncture and, if possible, administerantibiotic treatment. Inasmuch as any infection is potentially dangerous, and because in many cases the fastestrelief from dental pain is to eliminate infection, assistance from someone able to administer orprescribe antibiotics can be a wise decision. In cases where infection is rampant; if the problem seems unusually severe or if the paincontinues and is beyond tolerance even after using aspirin ...when there is a real doubt as to theproper course of action... consulting a physician or dentist --if available --is an option worthconsidering.1
  • 83. Chapter Fourteen - Diet, nutrition & oral health Generally speaking, whats good for the health of the whole body is also good for oral health.Thats not too surprising, considering the way our entire physical being is intended to exist innatural harmony. Conversely, the principal "problem foods" with respect to oral health are also problem foodselsewhere in the system. Consider sugar: Earlier you read that there has been a staggeringincrease in the amount of sugar consumed annually by Americans since the pioneer days. As anation, we are overweight, overtired, undernourished (thats right!), and generally ripe for cancerof the colon, heart attack, sugar diabetes... or, at the very least, an un-enjoyable "tired" retirement. It doesnt have to be so. Those who are at all familiar with published materials concerning diet will know aboutroughage; about the benefits of whole-grain products. Such people will also know that while weneed a certain amount of sugar...and sugar can be a most pleasant element of diet...we surely dontneed it in the kinds and amounts most people consume. In the chapters on oral hygiene, and particularly in the section dealing with the care ofinfants, the impact of sugar was fully discussed. Sufficient to say, here, that while sugar cannotdirectly damage teeth in a germ-free environment, it is the basic food of those germs. Realizingthat we are re-exposed to strep mutans and lacto almost every day of our lives, it just makes goodsense to avoid over-feeding any germs that have ideas about setting up housekeeping in ourmouths. Since a reasonable attitude toward sugar is good for us "all over," it isnt as though we aremaking some sort of sacrifice just for oral health. When people first set out to achieve freedom from dental problems --odontosis --there will bea period while the disease germs are still active. Although they will decrease; and with the properhygiene (sometimes with a little help from fluoride mouth rinses), they will eventually no longerhe present in numbers of more than 8,000 per mi. of saliva, there is still a period when specialcare of dietary habits will help. For the first three weeks when you begin your hygienic efforts, it is best to avoid as much asyou possibly can any of the foods from this list:1
  • 84. LISTA -- (avoid these) cake apple juice candy chocolate drinks cookies cocoa donuts Hi C drink graham crackers *Kool Aid ice cream malted milk Jell-O milk shakes pies Ovaltine sherbet *soft drinks sugar *juice drinks waffles pastries dates apple sauce figs canned fruit grapes custard honey dry cereal jam frozen fruit jelly *chewing gum molasses marshmallows pancakes peanut butter raisins pudding syrup white bread *with sugar As has been pointed out earlier, it is often the frequency of eating rather than what is eaten,that is bad for oral health. (It doesnt do the rest of you much good, either.) Some authorities arenow advising a number of light meals throughout the day for persons with specific physicalproblems, such as hypoglycemia or diabetes. This may be, in some cases, the only solution for aspecific physical condition. It is not recommended for oral health purposes and we are notconvinced it is good for physical health at all... unless a physician prescribes it as mandatory inresponse to a disorder. For our purposes: No snacks between meals for at least the first 21 days of your oral hygienemaintenance program. It would be good for you if you could carry the habit of not snacking withyou for the rest of your life. However, since many people simply cannot do without, or haventthe will-power, here is a list of foods which will do you the least harm:1
  • 85. LIST B -- (snacks) nuts carrots popcorn celery potato chips cheese corn chips Fritos radishes milk oranges beans bologna salami tomatoes olives Balanced, nourishing food thats good for your system is also good for your oral health. Thefollowing list will give you an idea of what foods are good for you and not harmful for oralhealth: You have a wide, pleasant variety. LISTC-- (wholesome foods) meat poultry fish seafood buttermilk popcorn grapefruit juice* nuts soup macaroni butter eggs nuts mushrooms cheese spaghetti margarine cooked cereal orange juice* puffed rice shredded wheat whole grain bread rye bread milk tomato juice *unsweetened fresh, frozen & canned vegetables: artichokes beans Brussels sprouts cabbage cauliflower corn eggplant lettuce onions peppers radishes squash tomatoes water cress asparagus beets broccoli carrots celery cucumber endive olives peas potatoes sauerkraut spinach turnips zucchini During the initial three weeks of your program, it is up to you to avoid sugar as much as1
  • 86. possible. For your information, the following is quoted from Money by The Mouthful: While you are developing your own personal hygiene; before youve had your clinical testsand have the confidence that youve completely controlled odontosis in your own mouth, youd bewell-advised to limit your use of foods with long sugar-retention times... For your guidance, we are going to give you a table showing the clearance times of variousfoods. This table will show the comparative times for each of these to "clear;" to reduce sugar-related acid production first to one-half of its immediate impact, and then to "safe" levels. % SAFE SAFE boiled potatoes 2.5 9.6 boiled macaroni 2.9 12.2 toffee 2.7 16.8 chocolate cream 2.9 16.1 caramel candy 3.2 18.8 milk chocolate 3.6 12.2 brown rye bread 3.8 18.9 white unsweetened bread. 4.0 20.1 wheat biscuits 4.0 21.1 wheat bread, sweetened 4.4 21.4 white sweetened bread 5.9 25.7 chewing gum w/sugar 7.4 42.2 (time in minutes) Source: Journal of Preventive Dentistry Obviously, the further down on the list you go. The longer it takes for the sugar-related acidactivity to falloff. Avoiding these foods is the best way to avoid the acid. If, however, you aregoing to eat any of these, you can see that "brushing after meals" in the case of many of the abovewill be a benefit. Its doubtful that youre going to jump right up from the table and head for atoothbrush, so the elapsed time for acid production to fall to 1/2-safe is a probable loss. You can,however, get to a brush in time to prevent some of the acid damage. Of course, oral acid production requires the interaction of two things: Sugar, and germs. If thegerms are not active, if they are free-floating in the oral environment (below 8,000 per mi.) thereis no way for them to produce acid damage. Remember that we are asking you to he extra careful with your diet, particularly with respectto sugar, for the first three weeks of your hygiene program. After you have had at least onesuccessful saliva test, the requirement for such watchfulness is greatly reduced. Without odontosis in the oral environment, the "rules" for diet and nutrition are the same asfor the entire whole-body system. In other words, whats good for a healthy "bed" is good for ahealthy mouth.1
  • 87. Chapter Fifteen – X Rays vs. Saliva Tests: ...which is best? By now it has become obvious that preventive medicine --or just plain commonsense living --is good for your whole body, your entire physical health. Were becoming more and moreconcerned about the effects of unnatural, man-made problems in our environment. Often suchsynthetic approaches were hailed as "miracle breakthroughs" when discovered... and, today, weare having serious second thoughts about some of them. For example: Radiation. When we first began unlocking the secrets of the atom; When wedeveloped X Ray machines for use by doctors, these were considered tremendous advances. Nowwe arent quite as sure about their benefits as we once were: At least, weve begun to view themwith a more cautious eye. X Rays are a diagnostic tool used by dentists almost as routinely as looking in peoplesmouths. Years ago, Oramedics Fellows found themselves using fewer X Rays...even beforenational awareness of radiation accumulation conditions in our environment. Why? --The use ofthe saliva test as a diagnostic device began to make X Rays more unnecessary. Since they (XRays) are an expense to both doctor and patient, and since they are largely redundant (who needsthem?) as a preventive diagnostic tool, they simply fell out of favor. Ordinarily if there is remedial dentistry which will have to he done at some point, a full seriesX Ray examination is made... once... and that is usually adequate. Contrast this to the "bite-wing"X Ray used by most conventional dentists which covers only one or a few teeth at a time and isused frequently... sometimes, in some practices, it is used every time the person visits the dentistsoffice. Now we know that X Rays arent necessarily the harmless "wonder" we used to think theywere. According to a report released in May 1979, by the National Academy of Sciences, there isno minimum level of exposure below which an individual is completely safe from future adversehealth effects. NAS spokesmen added that it may take as long as 30 years for adverse radiation-inducedproblems to appear; and that each exposure to radiation increases the danger. Radiation dangers appear to he more critical with the young, and with women: NAS estimatesthe danger to be twice as much for women as for men; people under 35 are apparently four timesas vulnerable as people over 50. In early 1979 only nine states had any licensing procedures... or required any specialtraining... for people who work with radiation. In one government survey, actual skin-dosagevaried by a factor of about 100 in 1,000 X Ray machines examined. Low-level radiation may well be the coming environmental problem of our time. We used tothink in terms of massive doses --such as associated with atomic warfare --but now, manyscientists are growing increasingly concerned about low-level accumulations. For example:Recent government estimates (which may be conservative) indicate that as many as ten fatalcancers may result from the Three Mile Island nuclear power plant accident in 1979. X Rays arealmost exclusively a diagnostic tool; with the exception of massive radiation therapy for cancer.In preventive dental practices, diagnosis is most usually done with a passive test... the saliva test...instead of with X Ray. Conventional dentistry uses the X Ray to diagnose symptom damage sothe damage can be mechanically corrected. Preventive dentistry is involved directly with diseasediagnosis, not symptom diagnosis... the X Ray is practically useless as a diagnostic tool as to thedisease itself instead of its symptoms. Dr. Arthur Upton, director of the National Cancer Institute, summed up the situation: "Withradiation, we have a preview of whats to come with other environmental agents. Radiation is1
  • 88. clearly useful, but we have to learn how to handle it in a way thats socially acceptable." X Rays are not the harmless, miraculous health "helps" we used to think they were. Instead,X Rays are something many people will want to avoid unless absolutely necessary. In a bookabout becoming dentally self sufficient, the message is clear: When theres nothing wrong withthe teeth, there is no need for X Rays; when we are dealing with the disease instead of itssymptoms, X Rays are not the best diagnostic tool. How much radiation does a person receive in an average dental X Ray? Heres a comparison,measured in millirems; the standard measure of radiation absorption by human cells: IN MILLIREMSFlight from Los Angeles to Paris (cosmic rays) 4.8Chest X Ray (l film) 22.0Contamination 1/2 mile from Three Mile Island during nuclear accident 83.0Apollo X astronauts on moon flight (cosmic rays) 480.0Dental X-ray (whole mouth) 910.0On-site dose at Three Mile Island accident 1100.0Breast mammography (1 film) 1500.0Current N.A.S. yearly occupational exposure accumulative limit 5000.0 It becomes questionable whether each visit to a dentist should be almost the equivalent ofvisiting a nuclear power plant during an "accident," or if it should "use up" almost one-fifth ofwhat the N.A.S. considers a yearly maximum for folks working around radiation.1
  • 89. Chapter sixteen - ...From now on A famous minister is supposed to have given his son some advice about preaching as theyounger man embarked on his career in the pulpit. He said, "Tell em what youre gonna tell em. Then tellem. Then tell em what you done toldem. Then shut up." At the front of this book we talked about helping you become dentally self-sufficient. It wasour intention, we said, to put enough between the two covers of a book that you and your familycould achieve freedom from odontosis and have a fairly good idea about how to respond to oralhealth emergencies as they arise. Then, through some fifteen chapters, we proceeded to do just that. It is our hope that, withcareful reading and... from time to time... returning to the reference chapters, you will have in onebook all thats needed to make a dynamic difference in the oral health of your entire family. We realize that many readers are not quite done with the dental profession. For most, there isexisting odontosis-symptom-damage that, sooner or later, will have to be corrected surgically: Inother words, a Doctor of Dental Surgery is going to have to fill some teeth, or make some othercorrections such as root canals or possibly bridges. We hope youve "gotten the message" enough that youll avoid letting any dentist extract anyof your teeth; at least not without getting another opinion, hopefully from an Oramedics Fellow. At least, we are confident that if you follow all of the suggestions weve made in this book,you should be looking at your last trip to the dentist. We dont rule out accident, or very grave disease problems, as something which you shouldcarefully consider before trying to "go it alone" if medical or dental assistance is available. Someproblems are simply beyond the capability of lay people to handle; some even probably beyondthe capability of a doctor, without the equipment and medicines he would have in his office. At any rate, weve completed the assignment: We told you what we were going to say; thenwe said it, and now weve told you what we just said. It is time, as the preacher so elegantly put it,to shut up. And yet thats not the easiest thing in the world to do, since it seems there is so much in thehealth care field that people ought to know...far too much for any one book. Wed like to mentiona number of other things; for example that the Kenalog in Orabase youd use for canker sores willwork just as well for herpes simplex virus lesions anywhere else on the body... in fact, Orabasewith Benzocaine would be a whole lot better than nothing, in that case... With the ever-increasing costs of health care and the growing public suspicion that people arenot getting a fair shake from the professions, it seems that more books like this one aredesperately needed. Earlier we talked about the frustration at a N.A.S.A. convention where skilled bio-engineering personnel and representatives of the dental profession were ecstatic over equipmentwhich would allow "business as usual" even on the moon. We dont live on the moon. We live on Planet Earth, and all is not well here: More and moreof our people are in isolated circumstances with respect to health care. This is an unfair situation.Given the technology at our disposal, and the delivery systems available to us, we could makefirst class health care available to everybody. If this is beginning to sound a bit like a sermon, dont panic. Well follow the rules; well "shutup." For now --for this book.1
  • 90. But maybe well be back... Robert 0. Nara, D.D.S. & Steven A. Mariner1
  • 91. Other titles by Dr. Nara are also available... Money By The Mouthful What you should know about the health of your mouth & body... that NO doctor is going to tell you! Hardcopy: $17.95 Disk: $7.95 Email: $6.95 WHAT MAKES JOHNNY RUN? The Psychology of Dentists and Todays Dental Profession Hardcopy: $17.95 Disk: $7.95 Email: $6.95 RESEARCH ADVOCATES ORAMEDICS Hardcopy: $4.95 THE 180-DEGREE THEORY How to Become Mentally Self-Sufficient 8.5 x 11" bound hardcopy: $17.95 Disk: $7.95 Email: $6.95 FEELINGS An Encounter with Yourself Hardcopy: $17.95 Disk: $7.95 Email: $6.95 Send Checks/ Money Orders to: OraMedia PO Box 496, Elmira, NY 14902 Please make checks payable to "Cornwell"1
  • 92. Products...1. First on the list is the Via-jet, model 7500 oral irrigator. It has a number of features that makeideal for use in anti-infective therapy programs. The Via-jet may be used with any microbialsolution and has a large capacity see-through reservoir, fully adjustable pressure control and sleekEuropean styling. Each unit comes with 2 standard tips and 2 sulcus tips.Two different attachments are available for deep pocket dis-infection/irrigation. The Pocket TipAdapter is a small Luer Lok adapter which attaches a sub-gingival cannulae directly to thehandle. The OraGator II Hand piece is more expensive but easier to use.Via-Jet, Model 7500 $69.95Extra Reservoir $14.95Pocket tip Adapter $14.95 (Cannulae Tip for deep cleaning)OraGator II Hand piece $33.95 (MP400)Replacement Sulcus tips $ 3.95 (2)Note: The regular tip and the sulcus tip are for cleaning pockets up to 4mm deep. The cannulaetip is for cleansing of deeper pockets.WaterPik Adapter $14.95 (Cannulae)OraGator II Hand piece $33.95 (MIP300 - for Water Pik)2. TheraSol Anti-microbial Rinse is especially suited for use in home care programs. It is aprofessional strength, highly substantive, bactericidal agent, but it doesnt stain the teeth likechlorhexidine based products and is less expensive than prescription products.TheraSol may be used right in the reservoir of the Via-Jet or Water Pik and is a superb breathfreshener and may be used in place of tooth pastes.16 oz. Pre mixed $15.95/bottle16 oz. Concentrate $35.95/bottle3. Merfluan EcoDent If you prefer all-natural products, EcoDent is your item. EcoDent isbased on an old European formula composed of baking soda, tartaric acid, myrrh, sea salt andnatural mint flavors. Natural anti-microbial powder.130ml $11.95 (1)Case $86.95 (12)1
  • 93. 4. Sonicare Quad Pacer electric toothbrush is the first of a new generation of sonic toothbrushes.The Sonicare uses high frequency vibrations in a way that is completely different from traditionalbrushes. The Sonicares bristles move at infrasonic speeds of 31,000 cycles per minute. Anelectronic smart timer is built into the handle for proper 2-minute brushing. Completely solidstate, the Sonicare Quad Pacer comes with a 2-year warranty, 2 brush heads and a 30 day, fullreturn policy.Quad Pacer $159.95Extra Brush Head $ 21.95 If you would like a free newsletter sent to your E-mail address, send request to The OraMedia - Dental Self-Sufficiency web site is: